• Cai Tian, Xiaodong Li, Zijie Fu, Yiwei Han, and Jingqiao Liu.
• The First Hospital of Hebei Medical University.
• Medicine (Baltimore). 2022 Dec 30; 101 (52): e32451e32451.

IntroductionLeydig cell tumor (LCT) is a sex cord-stromal tumor, which is a clinically rare ovarian tumor. It is characterized by endocrine hormonal changes and usually occurs in postmenopausal women.Patient ConcernsWe report the clinical case of a 38-year-old female of childbearing age with LCT of the right ovary who presented with significantly decreased menstrual flow and elevated androgen levels, with persistent hypoechoic areas in the ovary as demonstrated by transvaginal ultrasound.DiagnosisThe transvaginal ultrasound suggested the presence of a hypoechoic area in the right ovary with elevated androgens, interstitial tumor of the ovarian sex cord may be considered.InterventionsThe patient underwent laparoscopic right adnexectomy.OutcomesPostoperative pathology confirmed the morphology and immunohistochemistry of the right adnexa consistent with LCT, and no areas of malignant transformation were found on multiple sections of the surgical specimen. The patient had normal androgen levels at postoperative day 2, day 45 and month 3. There was no sign of recurrence.ConclusionThis case suggests that when women of childbearing age have abruptly decreased menstrual flow with increased testosterone, clinicians should pay attention to intra-ovarian occupying lesions and consider the possibility of LCT. In such cases, ultrasound examination can determine the presence, location, shape and size of occupying ovarian lesions and play an important role in the diagnosis of condition.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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