An Occult Leydig Cell Tumor in a Postmenopausal Woman Presenting with Alopecia and Hirsutism: A Case Report

    January 2021 in “ touchREVIEWS in Endocrinology
    Shuann Shwana, Natasha Shrikrishnapalasuriyar, Win Yin, Monica Vij, Atul Kalhan
    TLDR Surgery removed an ovarian tumor, improving her symptoms and normalizing testosterone levels.
    This case report described a 68-year-old postmenopausal woman who presented with rapidly progressive hirsutism and male-pattern alopecia, symptoms indicative of hyperandrogenism. Despite elevated testosterone levels, multiple radiological investigations failed to identify an androgen-secreting tumour. The patient underwent an elective bilateral salpingo-oophorectomy based on clinical suspicion, which confirmed the presence of an occult Leydig cell tumour (LCT) in the ovaries. Post-surgery, her symptoms improved significantly, and testosterone levels normalized. LCTs are rare, accounting for less than 0.1% of ovarian tumours, and are typically benign and unilateral. The report highlighted the challenges in diagnosing such tumours due to their small size and the importance of considering ovarian sources in postmenopausal women with significant hyperandrogenism.
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