Hidden Behind PCOS: An Androgen-Secreting Ovarian Steroid Cell Tumor in a Young Woman

Ovarian steroid cell tumors are rare sex-cord stromal tumors, representing less than 0.1% of all ovarian tumors. They frequently produce steroid hormones and present with endocrine manifestations such as hirsutism, virilization, and menstrual irregularities. We report a case of a 21-year-old unmarried woman presenting with irregular menses and clinical hyper-androgenism. Imaging revealed a right ovarian mass, and serum testosterone was markedly elevated. Laparoscopic cystectomy was performed, and histopathological evaluation confirmed a steroid cell tumor, not otherwise specified (SCT-NOS). The patient recovered uneventfully and was discharged on postoperative day three. This case highlights the importance of considering androgen-secreting ovarian tumors in young women presenting with virilization and elevated testosterone levels predominantly in cases of PCOS.