Endocrine Abstracts

Introduction: Ovarian steroid cell tumors are very rare, and are endowed with steroid-secreting capacity. Most often, they are virilizing. Ovarian steroid cell tumours NOS, even if are rare, should be considered in any case of hyperandrogenism and excluded if elevated androgens levels are present. Our case illustrates this exceptional entity.

Case report: A 47-year-old female presented with virilism associated with severe hirsutism, frontotemporal baldness and muscular and clitoral hypertrophy. Biological work-up revealed an increase in androgens (total testosteronemia 12.75 ng/ml), with no associated hypercorticism. Pelvic MRI showed a suspicious left ovarian mass classified as ORADS5 The patient underwent left adnexectomy. Anatomopathological examination concluded that the ovarian stroma was a steroid cell tumour. Post-operative management was straightforward and the patient was placed under observation.

Discussion and conclusion : Steroid cell tumors are defined as ovarian neoplasms composed of cells secreting steroid hormones and represent less than 0.1% of ovarian tumors. They generally occur in adults, with an average age at diagnosis of 47. In 50% of cases, they are virilizing tumors. They may be non-secreting, causing hyperestrogenism or, more rarely, Cushing’s syndrome. They are generally benign, but the potential for malignancy is not negligible, given well-defined histological criteria. Good ovarian imaging is essential in the assessment of hyperandrogenism without associated adrenal abnormalities. Treatment is usually surgical. Complementary therapies are required once malignancy has been confirmed.