Steroid Cell Ovarian Neoplasm, Not Otherwise Specified: A Case Report and Review of the Literature

Abstract

Background. Steroid cell ovarian tumors, not otherwise specified, represent a unique cause of female virilization. Most commonly encountered in premenopausal women, these tumors can exist throughout a women's lifetime, from before puberty until after menopause. Case. Steroid cell, not otherwise specified, was diagnosed in a 70-year-old female significant for hirsutism. The patient demonstrated elevated total testosterone levels with normal gonadotropins, DHEA, and DHEA-S levels. CT imaging revealed a right ovarian mass and subsequent laparoscopic right oophorectomy yielded clinical improvement promptly. Conclusion. Virilization in females can occur based on ovarian or adrenal pathology. In terms of ovarian-based female virilization, many tumors exist that may induce women to demonstrate masculine features, such as pure Sertoli, pure Leydig, Sertoli-Leydig combinations, and gynandroblastomas. Each of these tumor types possesses a unique histologic pattern that allows for pathologic identification after removal. A rare source of ovarian-based female virilization is steroid cell neoplasms, not otherwise specified, that do not demonstrate these specific histologic characteristics and thus represent a diagnosis of exclusion after other causes of ovarian-based female virilization have been ruled out.

Steroid cell tumour of the ovary: a case report with review of literature

“…1,3 Steroid cell tumours of the ovary are identified based on the absence of pathognomonic features, seen in other androgen secreting ovarian tumours such as Reinke Crystals, Call-Exner bodies, and prominent nucleoli. 4 Typically, a menstruating female will first notice oligomenorrhea followed by amenorrhea. 10 The small solid ovarian tumours can be detected by carefully assessing the texture of the ovary using grayscale ultrasonography.…”

“…However close surveillance of child bearing women undergoing unilateral oophorectomy is necessary because there is 5% possibility of contralateral involvement. 4 If the patient has completed the family; hysterectomy, removal of the contralateral ovary and complete surgical staging are recommended. 4 …”

“…4 If the patient has completed the family; hysterectomy, removal of the contralateral ovary and complete surgical staging are recommended. 4 …”

“…1,3 According to the WHO, the androgen secreting steroid cell tumours are further classified as either pure sertoli, sertoli-Leydig, gynandroblastomas, or steroid cell, NOS, wherein steroid cell, NOS is the most common type accounting for approximately 60% of steroid cell tumours. 4 Historically these tumours have been referred to as lipoid cell tumours, lipid cell tumours, luteomas, masculinovoblastomas, hypernephroid tumours, adrenallike tumours and adrenal rest tumours, since the exact lineage of the tumour is not known. 5,6 Initially, Morris and Scully described these tumors as ovarian epithelial tumours with functioning stroma.…”

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

“…Young and Scully [1], established four subclasses of SCT: stromal luteoma, Leydig cell tumor, steroid cell tumor of adrenal type and steroid cell tumor not otherwise specified (SCT NOS). SCT NOS is the most common subtype of SCT, accounting for approximately 60% of cases [4].…”