Rare case of testosterone producing serous cystadenoma

Postmenopausal virilization and symptoms of hyperandrogenism can be attributed to tumorous or nontumorous causes. Androgen secreting tumors can arise from either the ovarian sex cord/stromal cells or from the adrenal glands. Cystadenomas are relatively benign ovarian epithelial tumors that have rarely been implicated as the cause of hyperandrogenism. Histologically these tumors are classified as mucinous or serous. We present here a case of a 60-year-old postmenopausal female with symptoms of hyperandrogenism including hirsutism and virilization for one year. Labs were significant for high total testosterone levels persistently. On imaging, our patient was found to have a left adnexal cyst, which was subsequently removed and found to be of serous histology. Upon removal of the cyst, patients’ total testosterone levels normalized. Our case highlights the importance of including cystadenomas in the differentials when evaluating for tumorous causes of hyperandrogenism.