Postmenopausal Hyperandrogenism in a Patient With an Adrenal Adenoma: How Should We Approach It?

Abstract

ABSTRACT Objective: To report the case of a postmenopausal woman with adrenal adenoma and severe hyperandrogenism due to bilateral ovarian hyperthecosis. Methods: We describe the clinical findings and diagnostic tests used to determine the source of excess androgen. Results: A 57-year-old postmenopausal woman with a 3-year history of alopecia and hirsutism was referred for evaluation. Laboratory evaluations revealed an elevated testosterone concentration. Transvaginal ultrasonography was normal but computed tomography showed a left adrenal nodule. Ovarian and adrenal vein sampling showed a gradient of testosterone between peripheral and right ovarian veins. Her testosterone concentration normalized following treatment with a gonadotropin-releasing hormone agonist. Following bilateral oophorectomy, her elevated testosterone concentration returned to normal and signs of hyperandrogenism gradually receded. Conclusion: Suppression of gonadotropin-releasing hormone and both adrenal and ovarian venous sampling ...