Sertoli-Leydig Cell Tumor as a Cause of Elevated 17-OH Progesterone

Ya Yuan Nicole Chong; Jing Lin Jeslyn Wong; Xiao Hong Joella Ang; Yuan Ling Amanda Lim

doi:10.1210/jcemcr/luae013

Sertoli-Leydig Cell Tumor as a Cause of Elevated 17-OH Progesterone

JCEM Case Rep. 2024 Feb 5;2(2):luae013. doi: 10.1210/jcemcr/luae013. eCollection 2024 Feb.

Authors

Ya Yuan Nicole Chong¹, Jing Lin Jeslyn Wong², Xiao Hong Joella Ang³, Yuan Ling Amanda Lim¹

Affiliations

¹ Division of Endocrinology, Division of Medicine, National University Hospital, Singapore 119228, Singapore.
² Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, National University Hospital, Singapore 119228, Singapore.
³ Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore 169608, Singapore.

Abstract

Virilizing ovarian tumors are rare but a clinically important diagnosis in a patient presenting with hyperandrogenism. Workup of hyperandrogenism is challenging with a broad range of differentials, including adrenal and ovarian pathology, tumoral or nontumoral in nature. Baseline follicular-phase 17-hydroxyprogesterone (17OHP) measurement is part of the investigation algorithm, and elevated levels are often associated with nonclassic congenital adrenal hyperplasia (NCCAH), which can have its first presentation in adolescence or adulthood. This case describes a young adult woman of reproductive age presenting with menstrual irregularity, raised testosterone, and 17OHP. After extensive workup and serial follow-up, she was found to have a Sertoli-Leydig cell tumor of the left ovary and underwent successful laparoscopic salpingo-oophorectomy with normalization of her menstrual irregularity and biochemical resolution of her testosterone and 17OHP levels.

Keywords: 17OH progesterone; Sertoli-Leydig cell tumor; hyperandrogenism; nonclassic CAH; oligomenorrhea; testosterone.

Publication types

Case Reports