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The Steroid Profile of a Virilizing Ovarian Tumor

From the Departments of Obstetrics and Gynecology and Pathology and the Division of Reproductive Endocrinology at Duke University Medical Center, Durham, North Carolina, and the Department of Obstetrics and Gynecology and Division of Reproductive Biology at the University of California, Los Angeles, School of Medicine, Harbor General Hospital, Torrance, California.

Abstract

A case report of a 25-year-old female with a sex cord stromal virilizing ovarian tumor is presented. The pathway of ovarian steroid secretion in this tumor is elucidated with the dominant elements being pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, and testosterone. The tumor primarily made testosterone (T) with lesser elevations of androstenedione (A), dehydroepiandrosterone (DHEA), and dihydrotestosterone (DHT). Expert pathologic opinions differed whether this neoplasm was a Sertoli-Leydig tumor or a virilizing granulosa tumor; therefore, it was probably a gynandroblastoma. A unilateral salpingo-oophorectomy was performed and the patient promptly resumed normal ovarian function with ovulation.