{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:39:20Z","timestamp":1762508360009,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,18]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>A 64-year-old postmenopausal female patient presented with approximately 5\u2009years of intermittent spotting, progressive hirsutism and significantly increased libido and clitoral hypersensitivity with spontaneous orgasms multiple times a day beginning a few months prior. Initial hormone work-up revealed elevated total serum testosterone, androstenedione and 17-hydroxyprogesterone. Luteinising hormone, follicle stimulating hormone, estradiol, dehydroepiandrosterone-sulfate, thyroid stimulating hormone and prolactin were all within normal limits. Initial suspicions suggested an androgen-secreting tumour, likely in the ovary. The lesion was undetectable on transvaginal ultrasound and abdominal\u2013pelvic CT scan. Laparoscopic bilateral salpingo-oophorectomy was performed to remove the likely source of excess androgens. Visible gross lesions were not observed intraoperatively; however, bilateral Leydig (hilus cell) tumours were confirmed by histopathology. Serum testosterone, androstenedione and 17-hydroxyprogesterone levels were normalised postoperatively within 2\u2009weeks and 1\u2009month, respectively.<\/jats:p>","DOI":"10.1136\/bcr-2020-236427","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e236427","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Bilateral microscopic Leydig cell ovarian tumors in the postmenopausal woman"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7282-3116","authenticated-orcid":false,"given":"Taylor L","family":"Langevin","sequence":"first","affiliation":[{"name":"University of New England College of Osteopathic Medicine, Biddeford, Maine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Maynard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA"},{"name":"Department of Obstetrics and Gynecology, University of New England College of Osteopathic Medicine, Biddeford, Maine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Dewan","sequence":"additional","affiliation":[{"name":"Pathology Specialists of New England, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"2025082801353170000_13.12.e236427.1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0581"},{"key":"2025082801353170000_13.12.e236427.2","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1684\/ejd.2012.1692","article-title":"Skin academy: hair, skin, hormones and menopause - current status\/knowledge on the management of hair disorders in menopausal women","volume":"22","author":"Blume-Peytavi","year":"2012","journal-title":"Eur J Dermatol"},{"key":"2025082801353170000_13.12.e236427.3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/cen.13492","article-title":"Clinical case seminar: postmenopausal androgen excess-challenges in diagnostic work-up and management of ovarian thecosis","volume":"88","author":"Mamoojee","year":"2018","journal-title":"Clin Endocrinol"},{"key":"2025082801353170000_13.12.e236427.4","doi-asserted-by":"crossref","unstructured":"Dennedy MC , Smith D , O\u2019Shea D , et al . 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