A 19-year-old girl has secondary amenorrhoea, hirsutism, acne, and deepening voice over eight months. There is a firm 9 cm left adnexal mass. Serum testosterone is markedly elevated, DHEAS is normal, and inhibin B is raised. What is the most likely diagnosis?
- A Polycystic ovary syndrome
- B Congenital adrenal hyperplasia
- C Sertoli-Leydig cell tumour ✓
- D Leydig cell hyperplasia
Correct answer: C. Sertoli-Leydig cell tumour
Explanation
Sertoli-Leydig cell tumour (androblastoma) is an ovarian sex cord stromal tumour of young women that secretes androgens causing rapid virilisation, with raised testosterone and often raised inhibin B. Normal DHEAS with an adnexal mass points to an ovarian source and kills congenital adrenal hyperplasia, where DHEAS would be high. PCOS causes gradual hyperandrogenism without a solid virilising mass, and Leydig cell hyperplasia is bilateral and microscopic.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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