Steroid Cell Tumours: Rare Ovarian Tumours that Cause Hyperandrogenaemia in Postmenopausal Women

Abstract Background Diagnosing hyperandrogenemia in postmenopausal women is very difficult, because it occasionally manifests as excessive hair growth or no clinical manifestations, so it is often misdiagnosed or missed diagnosis. Ovarian steroid cell tumours that cause hyperandrogenaemia in women account for approximately 0.1% of all ovarian tumours. Due to the low incidence, corresponding imaging reports are rare, so ovarian steroid cell tumours lacks typical imaging findings to differentiate it from other ovarian tumours. Therefore, we summarized its clinical and imaging characteristics through this case series ,and we also elaborated on the differential diagnosis of steroid cell tumors. We hope to help clinicians have a deeper understanding of ovarian steroid cell tumours.Case presentation we report three cases of postmenopausal women with hyperandrogenaemia.Only 1 patient showed virilization symptoms, the other two patients were completely asymptomatic. All patients underwent total hysterectomy + bilateral adnexectomy. Histological results showed one case of leyding cell tumor (case 1) and two cases of benign non-specific steroid cell tumor (case 2 and case 3). After the operation, the androgen levels of all patients returned to normal, and there was no clinical recurrence since follow-up.Conclusions Through this series of cases, we found that although virilization caused by increased serum testosterone levels is an important clinical feature of ovarian steroid cell tumors, complete asymptomatic is also one of its features. A solid, slightly hypoechoic, round or oval mass with uniform internal echo, richer blood flow in the solid part and low resistance index are typical imaging features of ovarian steroid cell tumors. Diagnosis of ovarian steroid cell tumours after menopause is challenging, but surgery can be used for both diagnosis and clear treatment.