5116 Postmenopausal Hyperandrogenism due to Rare Ovarian Tumor

A 66-year-old postmenopausal woman with a history of diabetes and breast cancer presented with worsening alopecia and other signs of hyperandrogenism. Laboratory tests revealed elevated testosterone and androstenedione levels. Imaging showed a stable left adrenal nodule, but no ovarian abnormalities. Adrenal and ovarian vein sampling indicated the ovaries as the testosterone source. A multidisciplinary team recommended bilateral salpingo-oophorectomy (BSO), which revealed bilateral Leydig cell tumors and a left ovarian Brenner tumor. Post-surgery, the patient's alopecia resolved, and testosterone levels normalized. This case highlights the complexity of diagnosing hyperandrogenism due to rare ovarian tumors despite normal imaging.