Endocrine Abstracts

Steroid cell tumours are very rare ovarian sex cord tumours that account for only < 0.1% of ovarian tumours. We present an interesting case of a steroid cell tumour in a 17 year old girl referred with worsening hirsutism, weight gain of nearly 3 stones and oligomenorrhea over 2 years. Menarche with regular menstrual cycles was attained at the age of 13 followed by normal reproductive development. On examination, she had an elevated BMI of 33.7 and there was marked hirsutism with Ferriman-Gallwey score of 22. There was a strong family history of Polycystic Ovarian Syndrome and this was the presumed diagnosis until our clinic review. Investigations revealed Testosterone raised at 8.1nmol/l (NR <2.7), Androstenedione of 58.8 nmol/l(NR- 0-9). The rest of her hormonal profile was unremarkable. MRI of adrenal and ovaries showed normal adrenals but revealed a right ovarian mass of 5.1 x 4.3 cm. She was urgently referred to the gynaecological team and her case was discussed in the teenage and young adult Gynaecological MDT where she was listed for a right sided laparoscopic salpingo- oophorectomy. Following surgery, histopathology of the ovarian mass confirmed Steroid cell tumour. Predictors of malignant behaviour namely size> 7 cm, older age, significant mitotic activity, necrosis, haemorrhage and nuclear atypia were negative. Post-operative blood tests results 6 weeks later, showed normalisation of serum testosterone and androstenedione levels at 2.1 and 8.1nmol/l respectively followed by spontaneous resumption of menstrual periods 2 months later; hirsutism has not yet shown response, however she is only 4 months post-surgery. She remains under review with monitoring of her hormonal profile.