An Unusual but Important Cause of Hyperandrogenism in Women

    November 2018 in “ Endocrine Abstracts ”
    Fatima Alkaabi, Sara Haboosh, Ali Abbara, Karim Meeran, Jeannie Todd, Christina Fotopoulou, Alexander Comninos
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    TLDR A woman's high testosterone levels were caused by a rare ovarian tumor, not the initially diagnosed condition.
    In 2018, a 61-year-old woman with a history of facial hirsutism and frontal balding was initially diagnosed with ovarian hyperthecosis due to marked biochemical hyperandrogenism. Despite treatment with LHRH-analogue therapy, her testosterone levels remained elevated. Further investigation revealed a 1 cm ovarian Leydig cell tumor, a rare condition accounting for less than 0.5% of ovarian tumors. After undergoing laparoscopic bilateral salpingo-oophorectomy, her testosterone levels became undetectable, and her hirsutism improved while her alopecia stabilized. This case emphasized the importance of questioning initial diagnoses when features are inconsistent and considering the entire clinical picture, not just imaging results.
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