An 18-year-old girl presented herself with symptoms of androgen excess. The following hormonal abnormalities were detected: elevated testosterone, and 17-hydroxycorticosteroids excretion, suppressed: basal FSH. Ultrasound imaging revealed a solid tumor in the right ovary and fluid in the peritoneal cavity. A low flow resistance documented in the tumor parenchyma arteries (PI - 0.88, RI - 0.55, S/D - 2.21) and in the margin arteries (PI - 0.89, RI - 0.55, S/D - 2.14). A right adnexectomy was performed, and the tumor was determined to be a highly differentiated Sertoli-Leydig Cell Tumor. The patient remains free of disease symptoms since 12 months. A low flow resistance in hormone-producing tumors does not necessarily reflect their malignant potential, but may be due to there high metabolism rate. This phenomenon should be taken under consideration during differential diagnosis.

Keywords: hyperandrogenism, Doppler, transvaginal ultrasound, Sertoli-Leydig Cell Tumor