PT - JOURNAL ARTICLE AU - Taylor L Langevin AU - Karen Maynard AU - Anil Dewan TI - Bilateral microscopic Leydig cell ovarian tumors in the postmenopausal woman AID - 10.1136/bcr-2020-236427 DP - 2020 Dec 01 TA - BMJ Case Reports PG - e236427 VI - 13 IP - 12 4099 - http://casereports.bmj.com/content/13/12/e236427.short 4100 - http://casereports.bmj.com/content/13/12/e236427.full SO - BMJ Case Reports2020 Dec 01; 13 AB - A 64-year-old postmenopausal female patient presented with approximately 5 years 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–pelvic 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 weeks and 1 month, respectively.