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

Hadjkacem, F.; Ghorbel, Dorra; Safi, Wajdi; Charfi, Nadia; Chaabene, Kais; Boudawara, Tahia; Abid, M.

doi:10.1155/2020/6970823

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…Some studies even claim that these markers could facilitate the differential diagnosis of ovarian adenocarcinoma. 11,14 This correlates with the described case, as even after disease relapse, tumor markers remained within the normal range.…”

Section: Discussionsupporting

confidence: 90%

“…Hyperandrogenic tumors may also be associated with paraneoplastic manifestations, such as hypercalcemia, erythrocytosis, or ascites. 11 However, about 25% of patients with SCTs may have atypical presentations, without any symptoms of virilization. In these cases, the diagnosis is usually made postoperatively after histopathological verification.…”

Section: Discussionmentioning

confidence: 99%

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Failure of multiple surgical procedures and adjuvant chemotherapy in early-stage steroid-cell ovarian tumor treatment: a case report and literature review

et al. 2021

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Ovarian steroid-cell tumors (SCTs) are a rare subgroup of sex-cord tumors of the ovary, accounting for less than 0.1% of all ovarian tumors. Not otherwise specified (NOS) tumors are the most common subtype. More than half of patients with SCTs-NOS show hyperandrogenic symptoms. The primary treatment for SCTs is surgery, as most cases are early-staged and benign. Because of the low incidence of metastatic disease, there is insufficient reliable information on the role of adjuvant therapy and the most effective treatment regimen. In this report, a rare case of a recurrent SCT-NOS in a 36-year-old female patient without endocrine symptoms is presented, highlighting the significance of appropriate pathological evaluation and immunohistochemical testing for the accurate diagnosis of this malignancy, particularly in the case of hormonally “silent” tumors. The metastatic tumor described here showed no response to four courses of adjuvant chemotherapy after several debulking surgeries. Based on the clinical findings, the neoplastic etiology should always be considered during the resection of ovarian tumors to prevent possible disease dissemination due to inappropriate surgical techniques.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Failure of multiple surgical procedures and adjuvant chemotherapy in early-stage steroid-cell ovarian tumor treatment: a case report and literature review

et al. 2021

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“…Steroid cell tumors have been described as a very rare (<0.1%) class of ovarian neoplasm, with SCT-NOS, comprising between 50% and 60% of the subtypes within this category. 9 - 11 A review of the literature demonstrates that most patients present in their 30s to 40s with rapidly progressive hyperandrogenism leading to virilization., 2 - 4 , 9 - 11 though this tumor has also been described in postmenopausal women. 12 The typical hormone profile of SCT-NOS, has been consistently described as elevated 17-OHP, elevated testosterone, and normal DHEA-S. 9 , 10 Scheker and colleagues have also identified increased expression of enzymes (namely AKR1C3) associated with ovarian steroidogenesis in SCT-NOS, suggesting a potential biomarker and a more specific mechanism for hyperandrogenism with ovarian origins.…”

Section: Discussionmentioning

confidence: 99%

Virilization by an Ovarian Tumor: Presentation Is Not Always Acute

Wong

Ajmal

Buddhdev

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Androgen-producing steroid cell ovarian tumors are rare, comprising less than 1% of ovarian neoplasms, and can present with infertility and rapid virilization. Here we discuss the case of a 28-year-old woman who presented with an unusually insidious 2-year history of infertility, hirsutism, and clitoromegaly who was found to have an elevated serum testosterone and a left ovarian mass. She underwent oophorectomy and pathology revealed a steroid cell tumor, not otherwise specified (NOS), with no malignant features. Following surgery, the patient’s hyperandrogenic symptoms resolved with normalization of testosterone within 6 months, and she was able to conceive spontaneously. In reproductive-aged women with progressive hyperandrogenic symptoms, androgen-producing tumors, including those of ovarian origin, should be suspected. Thorough investigation, including plasma hormone levels and tumor histology, can lead to accurate diagnosis and management. Treatment should be guided by histology and surgical staging, with consideration for future fertility desires. Women who have not completed childbearing can undergo unilateral oophorectomy or tumor resection for benign tumors, with close monitoring of sex hormone levels postoperatively.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…Certain tumors may be so small that they may not be diagnosed even after careful radiological scrutiny ( 17 , 20 ). In the case of the present study, no obvious mass was observed on the right ovary on MRI.…”

Section: Discussionmentioning

confidence: 99%

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

Sun

Zhang

2022

Oncol Lett

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Ovarian steroid cell tumor is a rare type of ovarian tumor, accounting for ~0.1% of all neoplasms of the ovary. Patients suffering from this type of tumor exhibit virilization due to high testosterone levels. The present study reported a case of an elderly female patient with high testosterone serum levels, resulting in hirsutism and deepening of the voice. Magnetic resonance imaging did not reveal any solid ovarian tumor. However, gray-scale ultrasound indicated suspicious solid nodules on the right ovary. A clear outline of the tumor, characterized by ring-shaped uniform enhancement, was revealed by contrast-enhanced ultrasound (CEUS) scanning. In addition, laparoscopic resection of both fallopian tubes and ovaries confirmed the right ovarian steroid cell tumor. After the operation, the patient's symptoms were completely relieved and testosterone levels returned to normal. In the present study, a case of ovarian steroid tumor diagnosed by CEUS was reported, supporting the significant role of CEUS in the detection of adnexal tumors.

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

Cited by 9 publications

References 15 publications

Failure of multiple surgical procedures and adjuvant chemotherapy in early-stage steroid-cell ovarian tumor treatment: a case report and literature review

Failure of multiple surgical procedures and adjuvant chemotherapy in early-stage steroid-cell ovarian tumor treatment: a case report and literature review

Virilization by an Ovarian Tumor: Presentation Is Not Always Acute

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

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