Clinical, ultrasonographic, computed tomography and histopathological manifestations of ovarian steroid cell tumour, not otherwise specified: our experience of a rare case with female virilisation and review of the literature

Abstract

Careful medical history, physical examination, laboratory serum values and imaging studies are helpful in making the pre-operative diagnosis. Steroid cell tumours, NOS are usually benign, unilateral and characterised by the composition of two similar-appearing polygonal cell types. They differ from Leydig cell tumours in the lack of crystals of Reinke in their cytoplasm.

Ovarian Steroid Cell Tumor (Not Otherwise Specified): A Case Report of Ovarian Hyperandrogenism

“…They are usually positive for Melan A and negative for FOXL2 [1]. Of the different markers that have been reported to stain these tumors, inhibin has proven to be the most helpful to date, because most steroid cell tumors express this marker [14]. In our case, the tumor showed strong and diffuse positivity of tumor cells for inhibin and Melan A.…”

A rare cause of virilization; Ovarian steroid cell tumor, not otherwise specified (NOS)

“…Interestingly, pathologically benign tumors can behave in a clinically malignant fashion. Estradiol secretion by these tumors is not uncommon (6-23%) (15). The presented case had endometrial hyperplasia and polyp as a result of elevated estradiol level.…”

Cytological Findings of Ascitic Fluid with a Malignant Ovarian Steroid Cell Tumor: A Case Report and Literature Review

“…Clinicians should be aware of SCTs and consider them in the differential diagnosis of isosexual precocious puberty in children and virilization in adults. Between 25 and 43% of SCTs are reportedly malignant [2] . Hayes and Scully [1] identified 5 predictive clinicopathologic features of malignant SCTs: ≥ 2 mitotic figures/10 high-power fields (92% malignant), necrosis (86% malignant), a diameter of >7 cm (78% malignant), hemorrhage (77% malignant), and grade 2/3 nuclear atypia (64% malignant).…”

“…Ovarian SCTs are usually benign, but extraovarian spread is noted at the time of surgery in 20% of patients [1] , and the proportion of tumors that are clinically malignant ranges from 25 to 43% [2] . Therefore, preoperative evaluation, careful intraoperative inspection, and the determination of histopathological features, including immunohistochemistry, may be essential to the precise diagnosis of this malignancy.…”