Hormonal studies and Doppler flow imaging of ovarian lipoid cell tumors: report of two cases.

Ovarian lipoid cell tumors are very rare. We report two cases with abnormal menstruation, hirsutism, clitoromegaly and marked elevations of serum testosterone. Sonography revealed unilateral adnexal solid tumors. Flow velocity wave form study showed apparent flow within the tumor with the resistance index ranging from 0.42 to 0.49 in both cases. Unilateral oophorectomy and contralateral ovarian biopsy were performed. Frozen sections showed lipoid cell tumors without malignant change. During surgery, direct ovarian venipuncture showed a discrepancy in testosterone level in the bilateral ovaries of both patients and large ovarian-peripheral venous gradients in case 2. The testosterone concentration returned to normal postoperatively in both cases. Flow velocity wave form study and direct ovarian venipuncture are useful tools for evaluation of androgen-secreting tumors preoperatively and intraoperatively.