Case Report: Steroid Cell Ovarian Neoplasm in a Patient with Polycystic Ovarian Syndrome

Introduction: Polycystic ovarian syndrome (PCOS) is the predominant cause of hyperandrogenism in women of reproductive age. Ovarian steroid cell tumors are rare, accounting for less than 0.1% of all ovarian tumors, with approximately half of these classified as not otherwise specified (NOS). These tumors frequently present with hyperandrogenic symptoms and elevated serum androgen levels, and generally follow a benign course post-surgery.Case Description: We report the case of a 31-year-old female managed as PCOS, who presented with amenorrhea, hirsutism, and virilization. Initially managed as having a broad ligament fibroid, her condition was re-evaluated due to worsening symptoms. Laboratory tests showed elevated testosterone (8.6ng/mL) and high 17-OH progesterone (12.12 ng/mL), and imaging revealed a right-sided ovarian mass. Surgical intervention revealed a highly vascular right ovarian tumor, later confirmed as a steroid cell tumor (NOS) through histopathology. Postoperative recovery was notable for the resolution of hyperandrogenic symptoms and the return of regular menstrual cycles. The patient conceived within six months post-surgery and is currently 20 weeks pregnant without complications.Conclusion: This case underscores the importance of considering tumorous causes of hyperandrogenism in women with PCOS, especially when there is a rapid onset of symptoms and elevated testosterone levels. Prompt clinical suspicion and early identification are crucial to avoid delays in appropriate treatment.