Virilizing Malignant Steroid Cell Tumor: Leydig Cell Subtype in a 24-Year-Old Palestinian Female with Histopathological and Biochemical Challenges: A Case Report
April 2023
in “
Research Square (Research Square)
”
TLDR A young woman had a rare, aggressive ovarian tumor that was hard to diagnose and treat, leading to disease progression despite treatment.
A 24-year-old Palestinian female presented with virilization symptoms, abdominal cramps, and an irregular menstrual cycle, which did not improve with oral contraceptive pills. Imaging revealed a large pelvic mass, and hormonal studies indicated elevated dehydroepiandrosterone sulfate (DHEA-S) and cortisol levels. After an unsuccessful unilateral salpingo-oophorectomy, which initially suggested a steroid cell tumor-not otherwise specified, the patient developed metastatic disease. Subsequent treatment with 4 cycles of BEP chemotherapy showed no improvement. A case revision identified the tumor as a Leydig cell subtype, but even after 6 cycles of carboplatin-paclitaxel, the disease progressed. The patient was referred back to her local hospital for continued management. This case underscores the importance of considering ovarian steroid cell tumors in the differential diagnosis of virilization and the challenges in diagnosing and treating this rare condition.
