Ovarian Cyst/Tumor & High Testosterone in 21-Year-Old Woman: Understanding the Connection

Question
Hello,
I have a question about my sister.  First, to give you some background, she's 21; healthy (prior to this); family history of heart disease, diabetes, and acne (all on my father's side - mother's side is unknown).  She said recently she's been having acne breakouts on her chin and there's been some hair there (I don't know how long ago this started).  She went to the doctor who checked her testosterone levels which came back high (13% I believe).  She was told that this could be due to a cyst or tumor on her ovary.  I wanted to know if you agree with that or if there's something else that could cause that?  If it is a cyst how dangerous is that?  If it's a tumor how likely is it to be cancerous?  Lastly, what are her chances of being okay in either case - I know that a lot of other variables that factor in, especially IF it is cancer, but your best expert opinion would be GREATLY appreciated.  Thank you.

Answer
I doubt that your sister has any evidence of cancer. Ovarian cysts are very common and come and go very often without the women even being aware of them. The acne and hirsuitism is probably NOT due to any ovarian problem. However, if the doctor palpated an enlarged ovary, she should have been sent for a sonogram, which will show if there is, indeed, a cyst on the ovary or if the ovary is enlarged from a solid mass (tumor). If the diameter of the ovary is less than 5cm, we do nothing but observe. If the diameter of the ovary is larger than 6cm, then a cystectomy may be entertained, if there are symptoms (pain). If the sonogram shows that there is evidence of a solid tumor on the ovary, it may merely be a "dermoid cyst" and, again, depends on symptomatology to determine whether surgery is necessary.  Ovaries do not secrete testosterone and that is not the cause of the hair on her chin. Very often birth control pills will help with that (as well as the acne). Testerone values of 13 are not considered to be high. If she has any doubts, consult a gynecologist, but the first step is to get a sonogram. If the sonogram shows nothing, there is no cause for concern at all.