Selective Venous Sampling Prompting Unilateral Oophorectomy in an Adolescent With PCOS and Markedly Elevated Testosterone

The document discusses a case of an adolescent female with polycystic ovary syndrome (PCOS) and severely elevated testosterone levels of 344 ng/dL. When imaging failed to locate a mass, selective venous sampling (SVS) was used, which identified the right ovary as the source of hyperandrogenism. A laparoscopic right oophorectomy (removal of the right ovary) was performed, which confirmed PCOS and ruled out a neoplasm. Following the procedure, the patient showed rapid and sustained improvement in her hyperandrogenism. The study concludes that SVS can be a useful tool for localizing the source of severe hyperandrogenism in cases of adolescent PCOS. Furthermore, unilateral oophorectomy can be therapeutic for severe PCOS, even when a neoplasm is not present.