Selective venous catheterization relating to an ovarian lipid tumor

A 31 year old obese, hirsute nurse with clitoromegaly and amenorrhea of 17 years duration underwent ovarian wedge resection at age 16 followed by laparoscopy at age 22 without identification of the source of excessive androgen secretion. Selective left adrenal and ovarian vein catheterization, pelvic sonography, an abdominal CT scan and a 14 day dexamethasone suppression test suggested, but did not define, the source of this woman's excessive testosterone secretion, 804 ng% in plasma. When difficulty arises in catheterizing the right ovarian vein, as frequently happens, sampling the inferior vena cava at multiple levels may provide additional help in localizing the source of androgen secretion.