Abstract:

Ovarian steroid cell tumor-not otherwise specified (SCT-NOS) is an exceedingly rare subtype of pure ovarian stromal tumor with malignant potential. Due to its low incidence and nonspecific clinical manifestations, it is frequently misdiagnosed or overlooked, with only sporadic cases reported in the literature. We report a case of ovarian SCT-NOS in a reproductive-aged woman presenting with massive ascites. The patient was admitted with a six-month history of intermenstrual vaginal bleeding. Color Doppler ultrasound revealed a right adnexal mass accompanied by significant pelvic and abdominal effusion. Pelvic magnetic resonance imaging was performed. After that, the multi-disciplinary team recommended exploratory laparotomy. The patient underwent a right salpingo-oophorectomy with left ovarian biopsy. Histopathological examination confirmed the diagnosis of right ovarian SCT-NOS. The postoperative follow-up at one year showed no evidence of ascites recurrence or tumor progression. Based on this case and a comprehensive literature review, we discuss the epidemiology, clinical characteristics, diagnostic challenges (including differential diagnoses), management strategies, and prognostic factors of SCT-NOS, with the aims to enhance clinical awareness and provide references for the diagnosis and treatment of this rare entity.

Key words: Ovarian neoplasms, Ascites, Diagnosis, Therapy, Ovarian steroid cell tumor-not otherwise specified