Differential Diagnosis
- Single most likely diagnosis
- Luteomas: This condition is characterized by the presence of solid, multinodular ovarian masses, which are consistent with the ultrasonography findings in this patient. Luteomas are known to cause maternal and fetal virilization due to the production of androgens, leading to symptoms such as hirsutism, deepening of the voice, and clitoromegaly.
- Other Likely diagnoses
- Sertoli Leydig cell tumors: These rare ovarian tumors can produce androgens, leading to virilization symptoms similar to those experienced by the patient. However, they are less likely than luteomas given the specific presentation and ultrasonography findings.
- Theca lutein cysts: These cysts can occur in association with gestational trophoblastic disease or hyperreactio luteinalis, and can cause virilization. However, they are typically bilateral and multilocular, and the patient's presentation and ultrasonography findings are more suggestive of luteomas.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant ovarian tumors: Although less likely, malignant ovarian tumors can present with similar symptoms and ultrasonography findings. It is crucial to rule out malignancy to ensure timely and appropriate management.
- Rare diagnoses
- Polycystic ovarian syndrome (PCOS): While PCOS can cause hirsutism and virilization, it is less likely in this case given the acute onset of symptoms and the presence of solid, multinodular ovarian masses on ultrasonography.
- Corpus luteum cysts: These cysts can cause virilization, but they are typically unilateral and simple, unlike the bilateral, solid, multinodular masses seen in this patient.
- Androgen-producing adrenal tumors: These tumors can cause virilization, but they are rare and would not explain the ovarian masses seen on ultrasonography.