Postmenopausal Hyperandrogenism Associated With Synchronous Ovarian Brenner Tumor, Bilateral Leydig Cell Tumor, and Adrenal Mass

This case study describes a 66-year-old postmenopausal woman with hyperandrogenism, virilization, and an adrenal incidentaloma, who was found to have rare ovarian tumors: bilateral Leydig cell tumors and a Brenner tumor. Elevated testosterone and androstenedione levels, along with incomplete suppression in a dexamethasone test, pointed to the ovaries as the androgen source. Despite normal-appearing ovaries on imaging, laparoscopic bilateral salpingo-oophorectomy (BSO) was performed, confirming the tumors. Postoperatively, her alopecia improved, and testosterone levels normalized. This case underscores the importance of thorough diagnostic processes and interdisciplinary collaboration in managing complex hyperandrogenism cases in postmenopausal women.