A Diagnostically Challenging Case of Hyperandrogenism in a Postmenopausal Woman

    October 2024 in “ Journal of the Endocrine Society
    Md Shajjad Hossain, Sadaf Hossain, Bharti Gautam, Huijuan Liao, Salini Chellappan Kumar, David S. H. Rosenthal
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    This case study presents a diagnostically challenging instance of severe hyperandrogenism in a 70-year-old postmenopausal woman, characterized by elevated testosterone levels, excessive hair growth, male pattern hair loss, and weight loss. The primary consideration was ovarian hyperthecosis, but elevated 17-OH Progesterone suggested the potential co-existence of non-classical congenital adrenal hyperplasia (NCCAH) or a rare Sertoli-Leydig Cell Tumor (SLCT). Blood tests showed significantly elevated testosterone and 17-OHP levels, while imaging revealed a prominent left ovary. The case underscores the complexity of diagnosing hyperandrogenism in postmenopausal women and the importance of exploring differential diagnoses and analyzing laboratory results. The patient was referred for bilateral oophorectomy for definitive diagnosis and treatment.
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