A 28-year-old woman presents with virilisation, clitoromegaly, and a solid unilateral ovarian mass 6 cm in size. Testosterone is markedly elevated. The most likely diagnosis is:

• A Granulosa cell tumour
• B Thecoma
• C Fibroma
• D Sertoli-Leydig cell tumour (arrhenoblastoma) ✓

Explanation

Sertoli-Leydig cell tumour is the classic androgen-secreting sex-cord stromal tumour causing virilisation in women of reproductive age; elevated testosterone is the hallmark. Granulosa cell tumour secretes oestrogen and typically causes feminising effects (menorrhagia, endometrial hyperplasia). Thecoma also secretes oestrogen. Fibroma is hormonally inactive and associated with Meigs' syndrome (ascites + pleural effusion).

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.