Rare Ovarian Steroid Cell Tumor, Not Otherwise Specified (NOS) With Massive Ascites and Elevated CA125: A Case Report

Author(s): Yiqun Tang, Dandan Chu, Yanli Li, Bin Cai, Shuo Shi

Ovarian steroid cell tumor, not otherwise specified (SCT-NOS) is an extremely rare ovarian tumor. We reported a unique case with massive ascites and elevated CA125 in a 45-year-old woman who presented with persistent abdominal distention for one month. Preoperative diagnosis was suspected as a malignant ovarian tumor initially due to aggressive signs including markedly elevated CA125 and massive ascites. Therefore, an exploratory laparotomy was performed to prepare for a complete staging surgery once get the pathological evidence of malignancy. However, taking the result of the intraoperative frozen section examination into account, a conservative uniliteral adnexectomy was conducted. Eventually, the pathological diagnosis revealed a benign ovarian steroid cell tumor, not otherwise specified. During the stringent postoperative surveillance, the serum level of testosterone and CA125 decreased to the normal range within one month. At the one-year and two-year follow-up visits, the patient did not have any complaints, and the testosterone serum level remained within the normal range. This rare and unique SCT-NOS case may help gynecologists better understand the clinical behavior of SCTNOS, and a comprehensive assessment including clinical presentation, radiology, serum testosterone level, and intraoperative frozen section examination may provide guidance in making an operative proposal and choosing the optimal individualized treatment strategies.

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