Diagnosis of endocrinally active ovarian tumors

The preoperative localization of small occult ovarian or adrenal androgen-secreting tumors is difficult. Selective sampling of glandular effluent by retrograde venous catheterization constitutes a reliable combined radiographic-endocrine approach. Steroid gradients between peripheral and organ vein levels are suspicious of a tumor especially when the testosterone gradient is elevated, e.g. more than 2.7 ng/ml between ovarian and peripheral venous blood. Therefore, selective catheterization is currently the most sensitive method for detection of androgen-secreting tumors smaller than 1 cm in diameter.