9243 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 adrenal nodule, but ovarian imaging was inconclusive. Ovarian vein sampling indicated the ovaries as the testosterone source. A bilateral salpingo-oophorectomy (BSO) was performed, revealing bilateral Leydig cell tumors and a Brenner tumor. Post-surgery, the patient's alopecia resolved, and testosterone levels normalized. This case highlights the diagnostic challenge of postmenopausal hyperandrogenism and the necessity of BSO for accurate diagnosis and management, even when imaging appears normal.