Androgen-Secreting Adrenal Adenoma in a Postmenopausal Woman as a Cause of Hirsutism

Androgen-secreting adrenal adenomas are an exceptionally rare cause of hyperandrogenism, particularly in postmenopausal women. Hirsutism is a frequent clinical manifestation and warrants a comprehensive evaluation to distinguish between ovarian and adrenal sources. We present the case of a postmenopausal woman with a history of progressive hirsutism and virilization. Biochemical evaluation revealed elevated dehydroepiandrosterone sulfate (DHEAS) and total testosterone. Pelvic lesions were ruled out but abdominopelvic tomography revealed a 41 × 30 mm left adrenal mass. The remaining hormonal profile was unremarkable. The patient underwent left adrenalectomy, with immunohistopathological analysis confirming an adrenal adenoma. Postoperatively, her androgen levels significantly decreased, accompanied by clinical improvement in hirsutism. Although the vast majority of hyperandrogenic states in postmenopausal women are secondary to ovarian pathology, adrenal etiologies must be ruled out. Androgen-producing adrenal adenomas represent a rare cause of hyperandrogenism, and this case contributes further evidence regarding the clinical and biochemical behavior of these benign lesions.