Ovarian Leydig Cell Tumor: Cause of Virilization in a Postmenopausal Woman

A 57-year-old woman with a history of type 2 diabetes, arterial hypertension, and hypothyroidism presented with a 2-year history of postmenopausal virilism, which included symptoms such as hirsutism, hoarseness, hypertricosis, and hair loss. High testosterone levels were detected, and a 24 mm hypodense formation was found in her right ovary via a scan. Despite being treated with cyproterone acetate, her virilization symptoms persisted, leading to rehospitalization four years later. She exhibited severe hirsutism and an enlarged clitoris. Laparoscopic surgery revealed small ovaries without masses, and a bilateral adnexectomy was performed. A significant clinical improvement was observed three weeks post-surgery, and histological examination confirmed an 8 mm hilar Leydig cell tumor. The conclusion of the case report is that Sertoli-Leydig cell tumors are very rare and typically have a low potential for malignancy. Surgical treatment is the primary approach, and the prognosis post-surgery is generally good.