Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 10-1980

Massive ovarian oedema with production of testosterone

Clinical, biochemical, light- and electron microscopic, and immunocytochemical findings of a 13 1/2 year old girl with delayed menarche and signs of virilization due to massive oedema of the left ovary with activation of stromal cells (hyperthecosis) are presented. Testosterone and oestradiol production by large cells in the voluminous ovary was demonstrated by immunocytochemistry and radioimmunoassay. Massive ovarian oedema may result from partial or intermittent torsion of the mesovary interfering with venous and lymphatic drainage, but not with arterial blood flow.