Secondary Amenorrhea and Clinical Hyperandrogenism in a 34-Year-Old Female: Polycystic Ovary Syndrome or Not?

A 34-year-old female initially suspected of having polycystic ovary syndrome (PCOS) due to secondary amenorrhea and hirsutism was later diagnosed with an androgen-secreting juvenile granulosa cell tumor (JGCT). Despite initial PCOS treatment, her symptoms worsened, leading to further tests that revealed elevated testosterone and anti-Müllerian hormone (AMH) levels and a 12 cm adnexal mass. Surgical removal of the mass confirmed the JGCT diagnosis, resulting in significant improvement in hyperandrogenism and the resumption of regular menstrual cycles. This case underscores the need to consider androgen-secreting tumors in patients with significant hyperandrogenism and elevated AMH, even when PCOS is initially suspected.