A 28-year-old woman comes to the physician because of progressive facial hair growth and deepening of her voice that started 3 months ago. Six months ago, menses occurred at regular 28-day intervals with moderate flow. Menses now occur at irregular 35- to 45-day intervals and last 2 to 3 days. Her last menstrual period was 2 weeks ago. She takes no medications. The patient's mother died from infiltrating lobular breast carcinoma at age 60. Vital signs are within normal limits. Physical examination shows dark terminal hair on the chin and upper lip. Pelvic examination shows a normal-appearing vagina, cervix, and uterus. There is a palpable adnexal mass on the right side. Pelvic ultrasonography confirms a large ovarian mass. Which of the following is the most likely diagnosis?

Question

A 28-year-old woman comes to the physician because of progressive facial hair growth and deepening of her voice that started 3 months ago. Six months ago, menses occurred at regular 28-day intervals with moderate flow. Menses now occur at irregular 35- to 45-day intervals and last 2 to 3 days. Her last menstrual period was 2 weeks ago. She takes no medications. The patient's mother died from infiltrating lobular breast carcinoma at age 60. Vital signs are within normal limits. Physical examination shows dark terminal hair on the chin and upper lip. Pelvic examination shows a normal-appearing vagina, cervix, and uterus. There is a palpable adnexal mass on the right side.   Pelvic ultrasonography confirms a large ovarian mass.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Sertoli-Leydig cell tumors of the ovary arise from the sex cord stroma and secrete testosterone.  Therefore, patients typically have signs and symptoms of hyperandrogenism, including rapid-onset virilization (eg, hirsutism, clitoromegaly, voice deepening) and amenorrhea.

A 28-Year-Old Woman Comes to the Physician Because of Progressive