Selective Venous Sampling Prompting Unilateral Oophorectomy in an Adolescent With PCOS and Markedly Elevated Testosterone

Creator(s)

Kelsee Halpin, Children's Mercy Kansas CityFollow
Emily Paprocki, Children's Mercy Kansas CityFollow
Paige Eickhoff, Children's Mercy Kansas City
Douglas C. Rivard, Children's Mercy HospitalFollow
Sahibu Sultan M Habeebu, Children's Mercy HospitalFollow
Anne-Marie Priebe, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

4-2023

Identifier

DOI: 10.1016/j.jpag.2022.10.006

Abstract

Background

For adolescents with suspected polycystic ovary syndrome (PCOS) and severely elevated testosterone concentrations, imaging is recommended to assess for neoplasm. Selective venous sampling (SVS) can be considered when imaging is nondiagnostic.

Case

An adolescent female treated for PCOS had a peak testosterone of 344 ng/dL (11.9 nmol/L). Imaging did not localize a mass. SVS implicated the right ovary as the source of hyperandrogenism. Following laparoscopic right oophorectomy, pathology excluded a neoplasm and confirmed PCOS. She subsequently had rapid and persistent improvement in her hyperandrogenism.

Summary and Conclusion

Striking testosterone elevation can occur with adolescent PCOS. SVS is a tool for localizing the source of severe hyperandrogenism, yet unilaterality is not always diagnostic of a neoplasm. Unilateral oophorectomy could nonetheless be therapeutic for severe PCOS.

Journal Title

Journal of Pediatric & Adolescent Gynecology

Volume

36

Issue

2

First Page

103

Last Page

106

Keywords

Hyperandrogenism; Adolescent; Polycystic ovary syndrome; Peripheral catheterization; Oophorectomy

Recommended Citation

Halpin K, Paprocki E, Eickhoff P, Rivard DC, Habeebu SS, Priebe A-M. Selective venous sampling prompting unilateral oophorectomy in an adolescent with PCOS and markedly elevated testosterone. Journal of Pediatric and Adolescent Gynecology. 2023;36(2):103-106. doi:10.1016/j.jpag.2022.10.006