Virilization Secondary to Androgen Producing Ovarian Serous Cystadenoma

A 59-year-old Hispanic female presented with virilizing features, including a receding hairline and facial hair growth, which had been developing over a period of nearly 2 years. Her medical history was notable for a total abdominal hysterectomy, treated syphilis, obesity, and vitamin D deficiency. Elevated levels of total and free testosterone were found in her blood tests, while other hormone levels were normal. Imaging revealed a large cystic mass in the left adnexa, suspected to be a cystadenoma. The patient underwent a bilateral salpingo-oophorectomy, which confirmed the presence of a left serous cystadenoma. Postoperative follow-up showed no improvement in her hirsutism and virilization, but her testosterone levels normalized. This case highlights a rare instance of an androgen-producing ovarian serous cystadenoma causing virilizing features in a postmenopausal woman.