An adolescent with a giant ovarian cyst and hyperandrogenism: case report

Objective: To present a rare diagnosis of polycystic ovary syndrome (PCOS) after initial suspicion of malignancy. PCOS is a common endocrine disorder in adolescence characterized by hyperandrogenism and polycystic ovaries. Case Presentation: A 13-year-old female patient was referred for a giant mass noted on examination for metrorrhagia. She had previously presented for hirsutism and acne, treated independently. A multicystic abdominal tumor measuring 21 × 17 × 9 cm was identified, with a nodular image and negative tumor markers, but elevated testosterone and LH/FSH ratio. Therefore, video-assisted ovarian cystectomy was performed. Finally, the patient was diagnosed with PCOS and began hormonal therapy, with improvement of hyperandrogenism. Conclusion: In adolescents with large ovarian cysts, in addition to ruling out malignant neoplasms, PCOS should be considered as these may have similar clinical and radiological presentations.