Abstract #1406879: Not Always PCOS: A Case of Virilizing Steroid Cell Ovarian Tumor

Ovarian steroid cell tumors (SCTs) are a rare type of sex-cord stromal that account for 0.1% all ovarian tumors. These can occur at any age and typically secrete hormones such as androstenedione testosterone. We report young woman with known microprolactinoma who presented secondary amenorrhea virilization was found to have secreting SCT. A 32-year-old nulligravid history infertility evaluation amenorrhea. Three years ago, she developed oligomenorrhea subsequently hyperprolactinemia an 8mm pituitary microadenoma. Thyroid function tests IGF-1 the time were normal, no other workup obtained. She started on cabergoline, though after developing full body hives switched bromocriptine. Despite prolactin normalization from 69.9 14.7 ng/mL shrinkage adenoma 7mm 1 year therapy, amenorrhea, acne, new facial hair. Her testosterone elevated 212ng/dL states then diagnosed PCOS. In light clinical improvement mental health issues, self-discontinued her bromocriptine lost follow up. Upon current presentation reported last menstrual period 24 months continued acne hair, now temporal hair loss deepening voice. Ferriman-Gallwey score 20/36. did not signs Cushing’s syndrome. Repeat 195ng/mL, MRI showed 3mm microadenoma, resumed. Workup hyperandrogenism revealed 137ng/dL (ref 8-60), 972 ng/dL (41-262), DHEA-S 284 mcg/dL (84.8-378), 17-OH-progesterone 23ng/dL, hCG <0.5mIU/mL. Late night salivary cortisol levels 0.213, 0.429, 0.552mcg/dL (<0.090) ACTH 27.3pg/mL (9.72-63.3). CT scan normal adrenal glands. pelvic ultrasound 2.2cm left vascular mass. underwent salpingo-oophorectomy pathology confirmed 2.4cm benign tumor. Follow up surgery is currently ongoing. Amenorrhea despite severe >150ng/dL, male pattern baldness, vocal should prompt physicians consider androgen-secreting Our patient SCT—these lead precocious puberty in adolescents, adults, syndrome, infertility. reports significant postoperatively.