Successful laparoscopic resection of virilizing ovarian steroid cell tumor, not otherwise specified, in a 22-year-old woman: a case report and evaluation of the steroidogenic pathway

Abstract

Objective : Ovarian steroid cell tumor (SCT) is a rare tumor with steroidproducing ability. We report a 22 -yearold woman with secondary amenorrhea and hirsutism caused by an ovarian SCTnot otherwise specified (NOS), who underwent successfully laparoscopic resection of the tumor. Case report : A 22 -yearold null gravida woman presented to a hospital, having amenorrhea for 18 months and increasing facial hair. Physical examination revealed obesity (body mass index, 37.3 kg/ m 2 ) with evident facial and trunk hair. Total and free serum testosterone, and dehydroepiandrosterone sulfate levels were found to be elevated. Levels of serum adrenocorticotropic hormone, gonadotropins, cortisol, aldosterone, and ovarian steroids were observed to be within reference intervals. Although polycystic ovaries were not found, a hyperechogenic solid tumor (3 cm) was detected on transvaginal ultrasonography. Laparoscopic resection of the tumor was performed. One month postsurgery, total and free testosterone levels were observed to have decreased, and menstruation resumed two months thereafter. The patient was histologically diagnosed with ovarian SCT -NOS. Expression of ovarian steroidogenic enzymes, which are related to hyperandrogenism, was observed. No disease recurrence has been reported for more than 5 years postsurgery.

Ovarian steroid cell tumors, not otherwise specified: three case reports and literature review

“…Ovarian steroidogenic enzymes, including 3 β-HSD, P450c17, 5 α-reductase 1/2, 17 β HSD 5, and 17 β HSD 1, are obviously expressed in the SCTs-NOS tumor cells. However, no adrenal-specific steroidogenic enzymes such as P450c21, DHEA-ST, and CYP11B1/2 are found to be expressed in SCTs-NOS, indicating that adrenocortical hormones are not synthesized ( 48 ). Validated enzymes may be used as markers for differential diagnosis of hyperandrogenic ovarian disease in the future.…”

Recurrent steroid cell tumor not otherwise specified with elevated testosterone and prolactin concentrations and impaired glucose metabolism: a case report

“…According to a literature review, eight cases of SCT-NOS underwent laparoscopic oophorectomy, and only four cases underwent partial oophorectomy. 15 The patients who underwent partial resection were followed up for <5 years and had no recurrence of SCT-NOS. However, no previous reports showed a longer follow-up than this time.…”

Contrast‑enhanced ultrasound of ovarian steroid cell tumor, not otherwise specified: A case report

“…The most commonly used imaging techniques for this type of tumor are ultrasound and MRI. As demonstrated by transvaginal ultrasound, ovarian steroid cell tumors are solid tumors with a hypo-/iso-echoic, homogeneous or heterogeneous texture (10,(15)(16)(17), characterized by abundant blood flow signals (18). On MRI, steroid cell tumors appear heterogeneous and as medium-intensity solid mass interspersed with small cysts.…”

“…On MRI, steroid cell tumors appear heterogeneous and as medium-intensity solid mass interspersed with small cysts. The tumor is significantly enhanced following Gd-diethylene triamine pentaacetate injection, thus indicating hypervascularity of the tumor ( 6 , 16 , 19 ).…”