Virilising ovarian tumour in a postmenopausal woman after bilateral oophorectomy

Ovarian neoplasms are rare tumours of steroid cell origin. These tumours present clinically due to the associated excess production of either androgenic or oestrogenic gonadal steroid hormones. The clinical picture is dictated by the specific hormone(s) produced and influenced by the age of the patient. The case is a 59-year-old woman who presented with a five-year history suggestive of androgen excess. She underwent a hysterectomy and right-sided oophorectomy at age 28 years for dysfunctional uterine bleeding. Virilisation was confirmed on clinical examination and the testosterone excess biochemically localised to the ovaries. A left-sided oophorectomy was performed. The clinical picture and testosterone excess persisted after surgery. Follow-up radiological investigations identified adnexal material that on resection proved to be remnant ovarian tissue. Histopathology confirmed the presence of a steroid cell tumour within the remnant tissue. The biochemical androgen excess resolved and the clinical features improved dramatically.