Ovarian steroid cell tumor in a teenager masquerading as polycystic ovary syndrome: a case report and literature review.

backgroundAdolescent patients presenting with hyperandrogenic symptoms often receive a diagnosis of polycystic ovary syndrome (PCOS). However, accurate diagnosis is crucial because the symptoms of rare conditions, such as ovarian steroid cell tumor (OSCT), can mimic PCOS. An 18-year-old female presented with irregular menstrual cycles, hyperandrogenic symptoms, and obesity. Despite standard treatments for PCOS, symptoms persisted. Exploratory laparoscopic examination revealed an OSCT. Thorough hormonal profiling, imaging, and histopathological analysis confirmed the diagnosis. LITERATURE REVIEW: All OSCT and PCOS with their synonyms were searched in Pubmed on March 1, 2025. After limited the topic to tittle/abstract and then screened manually, only one report was found to present similar OSCT-NOS case with the case we report here.

conclusionThis case highlights the need for accurate diagnosis, early evaluation, and timely intervention in adolescents with hyperandrogenism to manage rare conditions like OSCT. CORE TIP: Adolescent females with hyperandrogenic symptoms are often diagnosed with polycystic ovary syndrome (PCOS). However, the symptoms of rare conditions like ovarian steroid cell tumors can mimic symptoms of PCOS. This case highlights the importance of an accurate diagnosis and a thorough evaluation through hormonal profiling, imaging, and exploratory laparoscopy. If the standard PCOS treatments are unsuccessful, then alternative diagnoses such as ovarian steroid cell tumor should be considered. Early identification and appropriate management are critical for satisfactory patient outcomes and emphasize the need for heightened awareness of rare conditions that present similarly to PCOS in adolescents.