A curative etiology of severe hirsutism with virilization – Sertoli Leydig cell ovarian tumor

ABSTRACT Hirsutism is one of the earliest manifestations of virilization. The most common cause of hirsutism in a reproductive-age woman is polycystic ovarian disease. Androgen-producing tumors of the ovary or adrenals will cause severe hirsutism and virilization. The biochemical measurements of total testosterone and dihydro-epi androstenedione sulfate are useful to localize the source of hyperandrogenism. The medical management of severe hirsutism with virilism is difficult in the idiopathic variety. However, the prognosis is excellent for androgen-secreting benign ovarian and adrenal tumors, and surgical resection is often the treatment option in most of these cases. In this study, we report a case of a 26-year-old female presenting with secondary amenorrhea with clinical features of androgen excess with virilization. The biochemical and imaging characteristics are suggestive of an androgen-secreting ovarian tumor. Following right oophorectomy, the histopathology and immunohistochemistry confirmed benign Sertoli Leydig cell tumor, and clinical and biochemical features normalized after 3 months of the curative surgical procedure.