Postmenopausal Hyperandrogenism: A Case of a Steroid Cell Tumor of the Ovary

A 48-year-old African American female with a history of PCOS and early menopause post-chemotherapy presented with symptoms of postmenopausal hyperandrogenism, including hirsutism, male-pattern baldness, acne, and elevated blood pressure. Lab work showed significantly elevated levels of total and bioavailable testosterone, among other results. Imaging revealed a 1.6 cm mass in the left ovary and a right adrenal nodule. After a total hysterectomy and bilateral oophorectomy, the left ovarian mass was identified as a steroid cell tumor, which is a rare ovarian tumor with malignant potential, comprising less than 0.1% of all ovarian tumors. The case highlights that severe hyperandrogenemia in postmenopausal women can indicate an ovarian or adrenal neoplasm, requiring prompt imaging and potentially additional diagnostic procedures. Surgical resection is the initial treatment, with chemotherapy as an option if the tumor is malignant.