An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report

Abstract

<i>Background</i>: Ovarian steroid cell tumors are rare tumors of the ovary characterized by steroid cell proliferation. These sex-hormone secreting tumors raise many differential diagnoses related to hyperandrogenism. Although most of these tumors are benign and slow-growing, approximately 25 – 43% of cases are clinically malignant. <i>Case</i>: We herein report a case of 30 years old woman with ovarian steroid cell tumor, not otherwise specified (NOS) with primary infertility. The patient presented with hirsutism and abdominal enlargement due to massive ascites during hospital admission. The blood test result showed significantly increased CA-125. Transabdominal ultrasound revealed a 7.81 x 4.94 cm tumor of the left adnexa. The patient underwent left salpingo-oophorectomy and responded well to the surgery. <i>Conclusion</i>: This case report presents a unique case of ovarian steroid cell tumor, NOS with findings of massive ascites, hirsutism, and a high level of CA-125. The findings were never associated with this type of tumor. The steroid cell tumor and its ascites could mechanically irritate the mesothelium that causing overexpression of CA-125. Surgery remains as the first-line treatment of this case. Adjuvant chemotherapy should be done based on the histologic type of the tumor and its surgical stage. Tumor marker decreased after surgery was done and patient remains alive and free of disease after a period of 2 years.