Rare case of occult testosterone‐producing ovarian tumor that was diagnosed by selective venous hormone sampling

Abstract

Abstract Case A 32 year old woman was referred because of secondary amenorrhea, hirsutism, and voice deepening. Outcome The blood testosterone level was markedly high. A transvaginal ultrasound revealed a small region in the left ovary, but whether or not it was a tumor was unclear. Therefore, selective ovarian venous sampling was performed. Consequently, the testosterone level was selectively increased in a blood sample that was taken from the left ovarian vein, the tumor was successfully localized, and a laparoscopic left oophorectomy was performed. Although the left ovary appeared to be normal at laparoscopy, the androgen‐secreting tumor was located within it. The tumor was diagnosed as a Leydig cell tumor by histopathological analyses. Conclusion This report demonstrates that selective blood sampling from ovarian veins before an operation is effective in localizing an androgen‐producing ovarian tumor that is difficult to diagnose by imaging studies.

Keywords

• diffusion‐weighted imaging
• Leydig cell tumor
• ovary
• selective venous blood sampling
• testosterone