{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:19Z","timestamp":1782489079319,"version":"3.54.5"},"reference-count":17,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,31]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>We present a case of a postmenopausal woman with androgenic alopecia and very high testosterone levels of 16\u2009nmol\/L (normal range 0.4\u20131.2). CT showed an enlarged right ovary with a high-density nodule and an incidental adrenal nodule. She underwent bilateral salpingo-oophorectomy and pathology confirmed a benign Leydig cell tumour of the right ovary and Leydig cell hyperplasia of the left. Testosterone levels improved to near normal postoperatively. Adrenal investigations favoured a benign adenoma, although adrenal androgen production could not be ruled out.<\/jats:p>\n                  <jats:p>This case highlights the challenges in investigating hyperandrogenism in postmenopausal women; the most common causes are ovarian and adrenal in origin. Leydig cell tumours are rare androgen-secreting benign ovarian tumours. The treatment of choice is bilateral salpingo-oophorectomy and provides cure in most cases.<\/jats:p>","DOI":"10.1136\/bcr-2025-268251","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:30:13Z","timestamp":1775842213000},"page":"e268251","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Leydig cell ovarian tumour: a rare cause of hyperandrogenism"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7323-1367","authenticated-orcid":false,"given":"Despoina","family":"Tseke","sequence":"first","affiliation":[{"name":"Diabetes and Endocrinology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safaa","family":"Malkat","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Younes","family":"Younes","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"2026062608154372000_19.4.e268251.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2021.06.008"},{"key":"2026062608154372000_19.4.e268251.2","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1210\/clinem\/dgac673","article-title":"Approach to Investigation of Hyperandrogenism in a Postmenopausal Woman","volume":"108","author":"Hirschberg","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2026062608154372000_19.4.e268251.3","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/cen.15265","article-title":"Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women","volume":"103","author":"Elhassan","year":"2025","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2026062608154372000_19.4.e268251.4","first-page":"26","article-title":"Bilateral Ovarian Leydig Cell Tumors in a Postmenopausal Woman Causing Hirsutism and Virilization","volume":"7","author":"Shakir","year":"2021","journal-title":"AACE Clin Case Rep"},{"key":"2026062608154372000_19.4.e268251.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.gore.2024.101345","article-title":"Leydig tumor in normal sized ovaries causing clitoromegaly: A case report","volume":"52","author":"Chavez","year":"2024","journal-title":"Gynecol Oncol Rep"},{"key":"2026062608154372000_19.4.e268251.6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.gore.2015.12.003","article-title":"Sertoli\u2013Leydig cell tumor of the ovary: A diagnostic dilemma","volume":"15","author":"Liggins","year":"2016","journal-title":"Gynecol Oncol Rep"},{"key":"2026062608154372000_19.4.e268251.7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000024922","article-title":"Clinicopathological analysis of ovarian sertoli-leydig cell tumor with postmenopausal vaginal bleeding as the first symptom","volume":"100","author":"Huang","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"2026062608154372000_19.4.e268251.8","article-title":"Postmenopausal Hyperandrogenism Associated With Synchronous Ovarian Brenner Tumor, Bilateral Leydig Cell Tumor, and Adrenal Mass","volume":"16","author":"Salim","year":"2024","journal-title":"Cureus"},{"key":"2026062608154372000_19.4.e268251.9","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1080\/09513590.2021.1897099","article-title":"Dexamethasone suppression test versus selective ovarian and adrenal vein catheterization in identifying virilizing tumors in postmenopausal hyperandrogenism - a systematic review and meta-analysis","volume":"37","author":"Tng","year":"2021","journal-title":"Gynecol Endocrinol"},{"key":"2026062608154372000_19.4.e268251.10","doi-asserted-by":"crossref","first-page":"234","DOI":"10.24976\/Discov.Med.202436181.22","article-title":"Review on Sertoli-Leydig Cell Tumours of the Ovary","volume":"36","author":"Muscat","year":"2024","journal-title":"Discov Med"},{"key":"2026062608154372000_19.4.e268251.11","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200211000-00010"},{"key":"2026062608154372000_19.4.e268251.12","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1080\/09513590.2021.1934443","article-title":"Occult symptomatic bilateral pure Leydig cell tumors in a postmenopausal woman: a case report","volume":"37","author":"Hussain","year":"2021","journal-title":"Gynecol Endocrinol"},{"key":"2026062608154372000_19.4.e268251.13","first-page":"1097","article-title":"Ovarian Leydig Cell Tumor and Ovarian Hyperthecosis in a Postmenopausal Woman: A Case Report and Literature Review","volume":"59","author":"Bu\u017einskien\u0117","year":"2023","journal-title":"Med Bogota Colomb"},{"key":"2026062608154372000_19.4.e268251.14","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13048-021-00805-0","article-title":"Ovarian sex cord stromal tumours: analysis of the clinical and sonographic characteristics of different histopathologic subtypes","volume":"14","author":"Jiang","year":"2021","journal-title":"J Ovarian Res"},{"key":"2026062608154372000_19.4.e268251.15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.5114\/pm.2020.99578","article-title":"Leydig cell ovarian tumor \u2013 clinical case description and literature review","volume":"19","author":"Klimek","year":"2020","journal-title":"pm"},{"key":"2026062608154372000_19.4.e268251.16","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-240937","article-title":"Ovarian Leydig cell tumor and postmenopausal hirsutism with signs of virilisation","volume":"14","author":"Ferrinho","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2026062608154372000_19.4.e268251.17","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.933126","article-title":"Ovarian Leydig Cell Tumor: Cause of Virilization in a Postmenopausal Woman","volume":"22","author":"Mourinho Bala","year":"2021","journal-title":"Am J Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:21:30Z","timestamp":1782487290000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,10]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bcr-2025-268251"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268251","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}