Androgenic Alopecia and Hirsutism in a 73-Year-Old Woman: Careful Re-Evaluation of Normal Imaging Findings May Lead to a Rare Diagnosis
May 2008
TLDR A 73-year-old woman's unusual hair loss and growth led to the discovery of a rare condition causing too much testosterone, which improved after her ovaries were removed.
In 2008, a 73-year-old woman was studied who developed androgenic alopecia (hair loss) and hirsutism (excessive hair growth) on her chest, back, and abdomen over 3-4 years. Despite initial 'normal' imaging results, a re-evaluation indicated her ovaries were larger than expected for her age. This led to the hypothesis of excess ovarian production of testosterone. After performing a bilateral ovarectomy (removal of both ovaries), the histopathological examination revealed stromal hyperthecosis, a rare condition causing excessive androgen production. Post-operation, the patient's testosterone levels normalized, and her hirsutism and androgenic alopecia improved. This case highlighted the importance of considering ovarian hyperthecosis as a potential cause of androgen excess in postmenopausal women, even when imaging studies appear normal.
