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Background: In girls the abrupt onset and rapid progression of hirsutism as well as additional signs of virilization are suggestive for an androgen secreting tumor from the adrenal gland or the ovary. Case presentation: A 13 7/12-year-old girl was referred for unexplained hyperandrogenemla. Since her menarche at the age of 12 10/12 years, she noticed a more rapid hair growth over her chest, abdomen, back, arms, and legs, but also new hair growth at the chin and upper lip.