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

  • Matsukawa Jun
    Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine
  • Takahashi Toshifumi
    Fukushima Medical Center for Children and Women, Fukushima Medical University
  • Hada Yurika
    Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine
  • Kameda Wataru
    Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine
  • Ota Kuniaki
    Fukushima Medical Center for Children and Women, Fukushima Medical University
  • Fukase Mika
    Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine
  • Takahashi Kyoko
    Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine
  • Matsuo Koki
    Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine
  • Mizunuma Hideki
    Fukushima Medical Center for Children and Women, Fukushima Medical University
  • Nagase Satoru
    Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine

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Abstract

<p>Objective: Ovarian steroid cell tumor (SCT) is a rare tumor with steroid-producing ability. We report a 22-year-old woman with secondary amenorrhea and hirsutism caused by an ovarian SCT-not otherwise specified (NOS), who underwent successfully laparoscopic resection of the tumor.</p><p>Case report:A 22-year-old 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/m2) 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 post-surgery, 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 post-surgery.</p>

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