Ovaries Reveal Their Inner Testes: A Case of Tumorous Hyperandrogenism

In 2019, a study was conducted on a 48-year-old woman who presented with symptoms of hyperandrogenism, including facial acne, baldness, hirsutism, deepening of voice, and amenorrhea, which had been progressively worsening over 5 years. Her testosterone levels were found to be abnormally high, while other hormone levels were normal. A CT scan showed normal adrenal glands and ovaries, but simultaneous adrenal and ovarian vein sampling revealed high testosterone levels from bilateral gonadal veins. A transvaginal ultrasound revealed right hyperthecosis. The patient underwent a laparoscopic hysterectomy with bilateral oophorectomy, and the final pathology was consistent with a 2.1cm left Leydig cell tumor and a normal right ovary. Postoperatively, the patient's testosterone levels normalized, and her symptoms resolved. The study concluded that tumorous hyperandrogenism is a very rare condition, often associated with rapid onset of virilization, and that androgen-secreting ovarian tumors, which are mostly benign, account for less than 0.5% of ovarian neoplasms. The case emphasized the need for careful evaluation and a high index of suspicion for this uncommon condition.