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

    Kelsee Halpin, Emily Paprocki, Paige Eickhoff, Douglas C. Rivard, Sahibu Sultan Habeebu, Anne-Marie Priebe
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    TLDR A special blood test helped find the overactive ovary in a teen with PCOS, and removing that ovary improved her condition.
    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.
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