Steroid cell tumour of the ovary (Not Otherwise Specified subtype) - A rare case report

Abstract

Ovarian steroid cell tumours are very
rare sex cord stromal tumours comprising
0.1 percent of all ovarian tumours.
These tumours are sub classified as stromal
luteomas, leydig cell tumours and
steroid cell tumour not otherwise specified
(NOS).These tumours are interesting
as they produce various hormones like
estrogen, testosterone, and cortisol. Occasionally
these tumours develop in
childhood causing precocious puberty
but they principally occur in perimenopausal
and postmenopausal women with
varying degrees of androgenic and estrogenic
features. We present one such
case of steroid cell tumour of ovary for its
rarity.A 42 year old perimenopausal
woman presented with complaints of increased
body hair growth and balding
past 2 years. OE there was increased
hair growth over the face, chest, abdomen
and limbs with temporal balding and
clitoromegaly.
Examination and radiological imaging revealed
a 5.5cm mass confined to Left
ovary with no extension to other pelvic organs
or abdomen. Her free testosterone
was elevated to 6.0ngml with normal CA-
125. A provisional diagnosis of a virilizing
ovarian tumour was made. Subsequently
staging laparotomy was done and HPE report
revealed Steroid cell tumour of ovary
(NOS). Stromal luteomas and Leydig cell
tumors are almost invariably unilateral and
benign. Steroid cell tumour of ovary (NOS)
accounting for 60 of the three tumours
have 40 malignant potential. Hence thorough
staging laparotomy and periodic follow
up with serial hormonal assays are required.