Characteristics of the major causes of gestational hyperandrogenism

Characteristic	Luteoma	Theca lutein cyst	Sertoli-Leydig tumor	Krukenberg tumor
Bilaterality	Approximately 47%	Approximately 96%	Approximately 5%	>80%
Maternal androgen excess	Approximately 35%	Approximately 30%	69 to 87%	80 to 100%
Fetal virilization	High if mother virilized	Very rare	High if mother virilized	80 to 100%
Malignant	0%	0%	Approximately 45%	100%
Ultrasound	Solid or cyst mass; typically larger than 4 cm Multinodular in 50% of cases; unilateral or bilateral; Color flow Doppler shows abundant circulation	Multiple hypoechogenic cysts with "spoke and wheel" appearance; lack of solid component	Solid, solitary, and usually unilateral	Typically bilateral ovarian masses
Androgen levels (ie, testosterone)	Increased	Increased	Increased	Increased

Adapted from: McClamrock HD, Adashi EY. Gestational hyperandrogenism. Fertil Steril 1992; 57:257.

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