Ovarian Tumor, Androgenic

Virilized

Step 1: View clinicals

A 33 year old woman presents with progressive hair growth on her face and chest for 6 months, and irregular periods occurring every 2 to 3 months, for 5 months. Prior to this, her menstrual periods occurred at regular 30 day cycles. Her medical history is unremarkable and she is not on any medications.


Step 2: Order all relevant investigations

Hormone profile

TSH, Estrogen, Prolactin, Progesterone, DHEAS, 17-OH Progesterone: normal Testosterone: 392 ng/dL (high) 48h low dose dexamethasone suppression test: cortisol & DHEAS suppressed; testosterone elevated

Ultrasound Abdomen & Pelvis

An abdominal and transvaginal ultrasound scan are performed. No abnormalities are detected.

CT Abdomen + Pelvis

The CT scan of the abdomen and pelvis shows no abnormalities.

Sampling of adrenal & ovarian veins

There are elevated testosterone concentrations in the right ovarian vein.


Step 3: Select appropriate management

R/S Oophorectomy
Dexamethasone
Antiandrogens
Pelvic radiotherapy


Score: ★★☆