Virilization, Ovarian Hyperthecosis, and Torsion Masquerading as Malignancy: A Case Report. uri icon

Overview

abstract

  • BACKGROUND: Premenopausal females with signs of androgen excess and oligomenorrhea are commonly evaluated for polycystic ovarian syndrome or for an androgen-secreting tumor if a pelvic mass is present. Ovarian hyperthecosis (OHT) as a cause of these symptoms in adolescents is rare. CASE: A 15 year-old female with primary amenorrhea and signs of virilization was referred to Pediatric and Adolescent Gynecology after pelvic imaging demonstrated a pelvic mass, suspected to be arising from the right ovary, and an adjacent paratubal cyst. Preoperative laboratory evaluation revealed markedly elevated testosterone levels (free testosterone 81.5 pg/mL [normal <7.5 pg/mL]; total testosterone 279.6 ng/mL [normal <52.0 ng/mL]). Ovarian tumor markers were otherwise normal. Surgical evaluation revealed bilaterally enlarged ovaries and right paratubal cyst with right ovarian torsion. Rather than demonstrating an androgen-secreting tumor, pathologic evaluation following right salpingo-oophorectomy resulted in an unexpected diagnosis of OHT. SUMMARY AND CONCLUSION: Our case demonstrates that OHT should be considered in the differential in the setting of a large pelvic mass and virilization in an adolescent.

publication date

  • December 7, 2024

Research

keywords

  • Ovarian Diseases
  • Ovarian Torsion
  • Virilism

Identity

Scopus Document Identifier

  • 85215233023

Digital Object Identifier (DOI)

  • 10.1016/j.jpag.2024.12.005

PubMed ID

  • 39653111

Additional Document Info

volume

  • 38

issue

  • 3