Abstract
Ovarian steroid cell tumors are rare sex cord-stromal neoplasms that may produce androgens and present with nonspecific gynecologic symptoms. Bilateral involvement is particularly uncommon and raises important diagnostic and therapeutic challenges in young women. We describe the case of a 25-year-old woman with bilateral adnexal masses who was evaluated with cross-sectional imaging and surgery, leading to the diagnosis of an ovarian steroid cell tumor. Definitive management was planned in a multidisciplinary setting and included surgical resection, adjuvant systemic treatment, and structured clinical, biochemical, and radiologic surveillance. The patient has remained disease-free on follow-up. This case underscores the importance of considering steroid cell tumor in the differential diagnosis of solid ovarian masses in reproductive-age patients, the central role of histopathology and immunohistochemistry in confirming the diagnosis, and the need to balance oncologic safety with fertility and endocrine considerations in young women with rare ovarian tumors.