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Polycystic Ovarian Syndrome with Unilateral Cystic Teratoma

From the Department of Obstetrics and Gynecology and The Pepper Laboratory, University of Pennsylvania School of Medicine and The University of Pennsylvania Hospital.

Abstract

A 20-year-old white female with hirsutism, oligomenorrhea and ovarian enlargement was studied using differential stimulation and suppression of adrenal cortex and ovaries. Although baseline urinary 17-ketosteroid levels were elevated, the patient exhibited normal adrenocortical suppression and stimulation and no increase in urinary 17-ketosteroids during the administration of dexamethasone combined with HCG. At laparotomy a benign cystic teratoma involving the entire left ovary was found. The right ovary had a characteristic polycystic appearance. A left oophorectomy and wedge resection of the right ovary were performed. Cyclic menses with biphasic temperature curves occurred for the first time after surgery, and pregnancy was established in 8 months. The patient's atypical response to dexamethasone and HCG and the possible role of the teratoma in the pathophysiology of her hirsutism are discussed.