Publication:

Rare cause of unexplained hypertension in an oligomenorrheic adolescent girl with adnexal mass: case report and review of literature

A 17-year-old girl with oligomenorrhoea was detected to have hypertension and right adnexal solid-cystic mass, 6×8 cm on ultrasound. Hormone profile was normal, CA-125 was 132.5 U/mL, other tumour markers were in normal range; though RMI-4 and ROMA index suggested malignancy. Patient underwent exploratory laparotomy, peritoneal wash cytology, right salpingo-oophorectomy, pelvic lymphadenectomy and omental biopsy. Intraoperative frozen-section revealed ovarian steroid cell tumour. Later, steroid cell tumour-not otherwise specified (SCT-NOS) was confirmed on histopathology and immunohistochemistry. When followed three months post-surgery, patient had resumed 30-32 days menstrual-cycle, and she was normotensive without medications. This case is being reported to emphasize that imaging though not recommended for evaluation of PCOS in adolescence; and measuring blood-pressure which is often skipped in young women; proved crucial in this patient.