Growing adrenal mass misdiagnosed as the cause of hirsutism in a patient with an ovarian Leydig cell tumor

A case is described involving a 71-year-old hirsute woman with a growing adrenal tumor and a high serum testosterone level, which did not normalize after adrenalectomy. Following this she was found to have a testosterone-producing ovarian Leydig cell tumor. This case provides key features that can help distinguish adrenal and ovarian causes of hirsutism.