Diagnostic challenges of androgen secreting tumor by sclerosing stromal tumor: A case report

Androgen-secreting tumors are rare ovarian or adrenal neoplasms associated with virilization symptoms such as hirsutism, deepening of the voice, and menstrual irregularities. These tumors present a diagnostic challenge due to overlapping features with conditions like polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia (CAH). Accurate diagnosis requires a combination of biochemical assays, imaging, and histopathological examination.

An unmarried 22-year-old woman presented with two years of irregular menstruation and recent onset of virilization symptoms. Besides clinical assessment, transvaginal ultrasound revealed a solid right ovarian tumor, raising suspicion of an androgen-secreting neoplasm. Histopathological examination following surgical excision resulted features consistent with a sex cord-stromal tumor, specifically a Sertoli-Leydig cell tumor. Further analysis revealed pseudo lobular architecture and spindle-shaped stromal cells confirming the diagnosis of an androgen-secreting tumor.

This case highlights the diagnostic complexities of androgen-secreting ovarian tumors. The challenge lies in distinguishing them from conditions like PCOS, emphasizing the need for a multidisciplinary approach that includes clinical, biochemical, radiological, and pathological assessments. The tumor's histological features were key in making the final diagnosis.

This report emphasizes the importance of considering androgen-secreting ovarian tumors in young women with unexplained virilization and menstrual irregularities. A comprehensive diagnostic approach is essential for accurate identification and appropriate management, ensuring optimal patient outcomes.