Objective: To determine the histogenesis of an unusual steroid cell tumor that occurred in the broad ligament.
Patient and methods: The tumor occurred in a 29-year-old woman who had evidence of virilization. The preoperative testosterone level was greater than 700 ng/dL, but it returned to normal after surgery. She was living and well without evidence of recurrent tumor 1 year after operation. The tumor was examined using light and electron microscopy and immunohistochemical stains.
Results: The tumor was composed of polygonal cells with prominent eosinophilic cytoplasm. No significant nuclear atypia or mitotic activity was identified; however, the tumor was large, and necrosis and hemorrhage were identified on gross and microscopic examination. A graafian follicle and a primordial follicle were present at the periphery of the tumor within the connective tissue stroma in one section, providing evidence for the presence of an accessory ovary. A separate normal ovary was present on the same side. The tumor mass was connected to the surface of the eutopic ovary by thin membranous tissue.
Conclusion: To our knowledge, we report the first case in the modern literature of an extraovarian steroid cell tumor arising in the broad ligament, and we present evidence supporting its origin from an accessory ovary.