Severe virilization in a girl with a steroid cell tumor of the ovary

We report a 6 year-old girl with striking signs of virilization, as well as elevated concentrations of testosterone and 17-hydroxyprogesterone. Although the elevated 17-hydroxyprogesterone concentration initially suggested late-onset 21-hydroxylase deficiency, she was found to have an ovarian mass by sonography which at surgery proved to be a hilus cell subtype of steroid cell tumor. This intra-ovarian tumor appears to be the smallest tumor of its type ever reported. The testosterone concentration was normal three days after tumor resection and has remained so two years later.