Gallbladder carcinoma presenting as a pelvic mass with elevated serum testosterone: a case report.

BACKGROUND: The differential diagnoses for pelvic masses with elevated CA 125 and serum testosterone are many, including primary tumors and metastases from nongynecologic primary cancers. CASE: A 63-year-old woman presented with a pelvic mass, abdominal pain and virilization. CA 125 and testosterone were elevated (74 U/mL and 384 ng/dL, respectively). Preoperative clinical diagnosis was suggestive of Sertoli-Leydig tumor. Final diagnosis was stage IV primary gallbladder malignancy with metastases to the ovaries. CONCLUSION: Ovarian metastases from other sites can clinically mimic primary ovarian tumors. In women with complex pelvic masses, metastasis should be considered as part of the differential diagnosis.