Postmenopausal Occult Ovarian Disease With Hirsutism: A 6-Year Follow-Up Course

May 2026 in “ Annals of Internal Medicine Clinical Cases ”

Swaraj Waddankeri, HEMANTH REDDY NUKALA, Meenakshi Masgal, Akhila Chava

androgenic alopecia hirsutism Leydig cell tumor testosterone androgen-secreting tumors postmenopausal hyperandrogenism

TLDR Leydig cell tumors can cause hormone issues in postmenopausal women even if imaging looks normal.

A postmenopausal woman with androgenic alopecia and hirsutism was found to have a Leydig cell tumor despite normal imaging, as indicated by elevated testosterone levels. Surgical removal of the tumor led to hormonal normalization and clinical improvement, highlighting the diagnostic challenge of detecting occult androgen-secreting tumors in postmenopausal women. This case emphasizes the importance of considering Leydig cell tumors in the differential diagnosis of postmenopausal hyperandrogenism, even when imaging does not reveal abnormalities.

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research Postmenopausal Hyperandrogenism

15 citations , May 2021 in “Climacteric”

Postmenopausal hyperandrogenism involves excess male hormones causing symptoms like hair growth and acne, and requires ruling out tumors and other disorders.

research Ovarian Leydig Cell Tumor and Postmenopausal Hirsutism with Signs of Virilization

4 citations , March 2021 in “Case Reports”

A woman's excessive hair growth and masculine features were due to a rare benign ovarian tumor and endometrial cancer, which improved after surgery.