Radiologically Occult Bilateral Androgen-Secreting Sex Cord-Stromal Tumors in a Postmenopausal Woman.

We present the case of a 66-year-old G3P3 postmenopausal woman with hyperandrogenism who presented with hirsutism and androgenetic alopecia and was subsequently diagnosed with bilateral sex cord-stromal tumors (SCSTs). These rare androgen-secreting ovarian neoplasms are typically unilateral and can be difficult to identify with conventional imaging. Despite negative imaging studies, persistent biochemical hyperandrogenism prompted bilateral salpingo-oophorectomy, which revealed bilateral androgen-secreting SCSTs. This case highlights the importance of maintaining a high index of suspicion for occult ovarian neoplasms in postmenopausal women with unexplained hyperandrogenism despite unrevealing imaging.