Steroid cell tumour of the ovary (Not Otherwise Specified subtype) - A rare case report

Ovarian steroid cell tumours are very rare sex cord stromal tumours comprising 0.1 percent of all ovarian tumours. These tumours are sub classified as stromal luteomas, leydig cell tumours and steroid cell tumour not otherwise specified (NOS).These tumours are interesting as they produce various hormones like estrogen, testosterone, and cortisol. Occasionally these tumours develop in childhood causing precocious puberty but they principally occur in perimenopausal and postmenopausal women with varying degrees of androgenic and estrogenic features. We present one such case of steroid cell tumour of ovary for its rarity.A 42 year old perimenopausal woman presented with complaints of increased body hair growth and balding past 2 years. OE there was increased hair growth over the face, chest, abdomen and limbs with temporal balding and clitoromegaly. Examination and radiological imaging revealed a 5.5cm mass confined to Left ovary with no extension to other pelvic organs or abdomen. Her free testosterone was elevated to 6.0ngml with normal CA- 125. A provisional diagnosis of a virilizing ovarian tumour was made. Subsequently staging laparotomy was done and HPE report revealed Steroid cell tumour of ovary (NOS). Stromal luteomas and Leydig cell tumors are almost invariably unilateral and benign. Steroid cell tumour of ovary (NOS) accounting for 60 of the three tumours have 40 malignant potential. Hence thorough staging laparotomy and periodic follow up with serial hormonal assays are required