SAT369 Rare Cause of Hyperandrogenism and Elevated 17 OH Progesterone Levels - Ovarian Steroid Cell Tumor (NOS)

Abstract

Abstract Disclosure: A. Shafi: None. G. Meier Surrey: None. Background:There are several causes of hyperandrogenism. We report a rare cause of hyperandrogenism and elevated 17 OH progesterone levels due to ovarian steroid cell tumor Clinical Case: A 21 yr old female presented to our clinic for evaluation of secondary amenorrhea and hirsutism for 2 years. She also endorsed deepening of voice and possible clitoromegaly. On physical exam she had hirsutism, acne with mild clitoromegaly. Labs were pertinent for normal TSH, Ft4, prolactin, DHEAS, am cortisol 14.85 ug/dl, ACTH 16 pg/ml (6-50), IGF-1 303 ng/ml (830-456), but elevated total and free testosterone 394.5 ng/dl (10-75), 70.5 pg/ml (0.2-5) respectively, elevated 17 OH progesterone 842 ng/dl (23-431 ng/dl depending on the menstrual phase). Due to testosterone >3x ULN, and significant symptoms of hirsutism/hyperandrogenism there was a concern for androgen producing tumor and therefore CT abdomen and Pelvis was obtained which showed “heterogeneously enhancing right adnexal mass measuring 6 x 5.1 x 5.4 cm causing leftward displacement of the uterus and left ovary. Right ovary was not identified and is likely inseparable from the right adnexal mass”. She underwent a laparoscopic Right salpingo oophorectomy with pelvic washings, peritoneal biopsies and omental biopsy. Pathology of ovary showed a steroid cell tumor, NOS. Pt seen 2 months post surgery pt reported that her menstrual cycles had become regular, however she continued to have acne and hirsutism for which she was referred to Dermatology. Post surgery 17 OH progesterone levels had normalized. Conclusion:Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. The clinical presentation may take many forms, including abdominal pain, distention, irregular menstrual cycles, and hirsutism. Labs can show elevated 17 OH progesterone levels. Therefore among other etiologies clinicians should also consider Ovarian Steroid cell tumor (NOS) as a possible cause for hypernadorgenism and elevated 17 OH progesterone levels Presentation Date: Saturday, June 17, 2023