01-24-2009, 06:36 PM
23 year old G0 cauasian woman presents with complaints of increased body and facial hair. She has noticed increased hair growth on her upper lip, chin, upper back, and lower abdomen for about 6 weeks. Upon review of systems, she also notes deepening of her voice and enlargement of her clitoris. None of the other women in her family have any of these symptoms and she feels quite self-conscious as a result. She underwent menarche at age 13, has irregular menses every 25 to 45 days and has never been sexually active. On physical examination, she is 5'6'' tall and weighs 114 lbs. She has some generalized acne on her back as well as some stubble on her cheeks and upper lip. Her escutcheon is diamond-shaped. A pelvic ultrasound shows a large adnexal mass that has both cystic and solid components as wells as septations. Her most likely diagnosis is
1. Sertoli-Leydig cell tumor
2. Congenital adrenal hyperplasia (CAH)
3. Testicular feminization
4. Polymenorrhea
5. Polycystic ovarian syndrome (PCOS)
1. Sertoli-Leydig cell tumor
2. Congenital adrenal hyperplasia (CAH)
3. Testicular feminization
4. Polymenorrhea
5. Polycystic ovarian syndrome (PCOS)