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Androgen-secreting ovarian tumour — SCE Endocrinology MCQ

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HardReproductive EndocrinologyAndrogen-secreting ovarian tumourSCE Endocrinology

A 30-year-old woman has severe hirsutism and voice deepening over 5 months. Testosterone is 8.9 nmol/L, DHEAS is normal and pelvic ultrasound shows a 3 cm solid ovarian lesion. 17-hydroxyprogesterone is normal. What is the most appropriate next investigation?

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Correct answer: C — Pelvic MRI and urgent gynaecology-endocrine MDT review

Rapid virilisation with markedly raised testosterone suggests an androgen-secreting tumour; ovarian imaging abnormality needs urgent characterisation and MDT review. Cosmetic treatment alone would delay tumour management. The pearl is that virilisation and rapid progression are red flags beyond PCOS.

Reference: Endocrine Society hirsutism guideline