Symptomatic ovarian steroid cell tumor not otherwise specified in a post-menopausal woman

Symptomatic ovarian steroid cell tumor not otherwise specified in a post-menopausal woman

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Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms.The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone.

An 80-year-old woman with worsening alopecia and excessive growth of coarse hair axon fixed blade on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL).Radiologic studies were consistent with bilateral adrenal adenomas.Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion.

A diagnostic and therapeutic bilateral salpingooophorectomy confirmed steroid cell tumor NOS of the left ovary.Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level.Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting odyssey baseball putter cover ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging.