Case Report: Postmenopausal Hyperandrogenism Misled by Adrenal Incidentaloma: A Rare Case of Androgen-Secreting Ovarian Adult Granulosa Cell Tumor and Clinical Implications

This case report highlights the importance of thorough evaluation in postmenopausal women with severe hyperandrogenism, emphasizing the use of MRI for detecting small tumors and comprehensive hormonal profiling to differentiate between tumorous and non-tumorous causes. It stresses the necessity of permanent pathology to prevent misdiagnosis and recommends surgical resection, specifically bilateral salpingo-oophorectomy, for managing androgen-secreting ovarian adult granulosa cell tumors (AGCT). Long-term follow-up is crucial due to the risk of late recurrence. The report also demonstrates that AGCT diagnosis can be achieved without inhibin B/genetic testing by integrating clinical, hormonal, and imaging data, aiming to raise awareness and reduce diagnostic delays.