Androgen Secreting Ovarian Tumors

Abstract

steroid cell tumors of the ovary are classified as sex cord-stromal cell tumor (granulosa and the coma-fibroma), sterol-stromal cell tumors, and mixed or unclassified and steroid cell tumors. Ovarian tumors that present with hyperandrogenism include Leydig cell tumors, Sertoli cell tumors, steroid cell tumors-not otherwise specified and ovarian thecomas. 5 Other rare ovarian causes of hyperandrogenism include gynandroblastoma, gonadoblastoma, ovarian carcinoid, surface epithelial tumors (Brenner tumor) and metastatic tumors. 5 These tumors are rare representing only 10% of all ovarian tumors. Tumoral cause of hyperandrogenism is suspected when the serum testosterone levels are significantly elevated (>200ng/ml), rapidly progressive symptoms of virilization or pelvic mass in examination/imaging. As mentioned earlier, symptoms and signs associated with hillar Leydig cell tumor may present as slowly progressive hirsutism. 6,7 When imaging does not identify ovarian or adrenal mass and the results of serum DHEAS are normal, then it is considered an indirect evidence of ovarian tumor if serum testosterone levels exceed 200ng/dl. These ovarian tumors secrete significant levels of testosterone or its precursor, and rostenedione.