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Ovarian androgen-secreting tumour — SCE Endocrinology MCQ

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HardReproductive EndocrinologyOvarian androgen-secreting tumourSCE Endocrinology

A woman develops rapid virilisation over six months. Testosterone is 9.5 nmol/L and DHEAS is normal; repeat LC–MS/MS confirms the result. Which localisation step is most appropriate?

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Correct answer: D — Arrange urgent ovarian imaging and specialist tumour evaluation

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as E

D is correct. Severe, rapidly progressive virilisation with markedly raised testosterone is a red flag for an androgen-secreting neoplasm; normal DHEAS points toward an ovarian source, so urgent pelvic imaging and specialist evaluation are appropriate. PCOS is generally slower and milder. Adrenal biopsy is unsafe and not first-line, a synacthen test evaluates selected CAH questions rather than tumour localisation, and empirical suppression must not delay assessment.

Reference: https://onlinelibrary.wiley.com/doi/full/10.1111/cen.15310