An Ovarian Steroid Cell Tumor Causing Virilization and Massive Ascites

Abstract

Steroid cell tumors, not otherwise specified (NOS), are rare ovarian sex cord-stromal tumors with malignant potential. The majority of these tumors produce several steroids, particularly testosterone. Various virilizing symptoms such as hirsutism, temporal balding, and amenorrhea are common in these patients; however massive ascites is an infrequent symptom. A 52-year-old woman with the sudden onset of virilization and massive ascites presented for treatment at Severance Hospital. After clinical evaluation, the patient underwent an exploratory laparotomy and a complete surgical staging procedure. She recovered from the surgery uneventfully and was discharged from the hospital five days after surgery. We present here an unusual case of an ovarian steroid cell tumor, NOS, and a brief review of the literature regarding these types of tumors.

Ovarian Steroid Cell Tumor Associated to Endometrial Hyperplasia and Presenting as Postmenopausal Vaginal Bleeding

“…Androgenic changes are proportional to the amount of testosterone secreted by these tumors [2]. Secretion of other hormones as estrogen (6-23%), cortisol (6-10%), prolactin or prorenin has also been reported, but is less common [15][16][17]. Excessive estrogen production can produce menorrhagia and even endometrial hyperplasia (such as the case of our patient) or endometrial adenocarcinoma at any age [2,3,15].…”

“…Ovarian tumor markers (CA125, CEA, Ca 19.9 and AFP) must also be analyzed to rule out ovarian adenocarcinoma [17]. They are usually negative in SCT [16].…”

Ovarian Steroid Cell Tumor: Report Of Four Cases

“…In the reproductive period, fertility protective surgery should be proposed as an alternative. As the rate of observing these tumors being bilateral is 6%, unilateral salpingo-ooforectomy in these patients would be sufficient (12) . Patients who do not have postmenopausal or fertility requirement, staged surgery should be conducted in those who have total abdominal hysterectomy and bilateral salpingo-ooforectomy and malignant criteria.…”

An ovarian steroid cell tumor with virilization and hypothyroidism: a case report

“…In young women with virilization or in young adults, steroid cell tumors in other locations should be sought [10,11]. Although the tumor with virilization and rarely associated massive ascites might look malignant clinically, the tumor might prove to be benign [12]. In young adult women with secondary amenorrhea, or in perimenopausal women with severe hyperandrogenism and virilization, Leydig cell tumor of the ovary should be considered [13,14].…”