Diagnostic challenges of androgen secreting tumor by sclerosing stromal tumor: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: ABSTRACT Introduction: 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. Case presentation: 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. Clinical discussion: 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. Conclusion: 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. Graphical abstract The histopathological examination of the right ovarian specimen suspected to be a sclerosing stromal tumor, such as a Sertoli-Leydig cell tumor, reveals a distinct pseudolobular architecture characteristic of sex cord-stromal tumors. The specimen exhibits pseudolobules dispersed within an edematous stroma, a hallmark feature that aids in differentiating this tumor from other ovarian neoplasms. Within these pseudolobules, the presence of both epithelioid and spindle-shaped cells is noted. The epithelioid cells demonstrate pale to clear eosinophilic cytoplasm, whereas the spindle cells possess a more fibrous eosinophilic cytoplasm, indicative of the tumor's stromal origin. The nuclei of these cells show no significant atypia, and mitotic figures are absent, suggesting the benign nature of the lesion. The ovarian cortex reveals the presence of primordial follicles, confirming the ovarian origin of the tumor and ruling out metastatic involvement. JOURNAL/ijscr/04.03/01612930-202504000-00007/figure1/v/2026-04-23T194637Z/r/image-jpeg Highlights
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4408029668