Ovarian Intratumoral 21-Hydroxylase Deficiency in a Postmenopausal Hirsute Woman

The document describes a case of a 64-year-old woman who developed virilization symptoms, such as hirsutism, hair loss, breast atrophy, and a deepened voice. Elevated testosterone and 17-OHP levels, along with a positive tetracosactin test, suggested a 21-hydroxylase deficiency. An ovarian nodule was discovered, leading to a bilateral laparoscopic oophorectomy. Histopathology confirmed a luteoma in the left ovary. After surgery, her hormone levels normalized within a month, and virilization symptoms improved within six months. This case was the first reported instance of intratumoral 21-hydroxylase deficiency in a postmenopausal woman, highlighting the need to consider virilizing ovarian tumors in similar presentations and the success of surgical intervention.