Uncontrolled Hypothyroidism and Ovarian ‘Tumors’: Cases and Review of Literature
Journal Title: GUJARAT CANCER SOCIETY RESEARCH JOURNAL - Year 2016, Vol 18, Issue 1
Abstract
Ovarian enlargement and ovarian cysts are associated with hypothyroidism. A decrease in ovarian volume, resolution of ovarian cysts and reversal of hyperstimulation like syndrome, has been shown to occur after the achievement of euthyroidism. The first case was of Van, Wyk and Grumbach syndrome. This syndrome is characterized by Juvenile hypothyroidism, isosexual precocious puberty, and multicystic ovarian masses with delayed bone age. In the second case an eight year girl had unilateral solid cystic enlargement of the ovary, mild ascites, raised serum LDH with severe hypothyroidism but no precocious puberty.The third patient had spontaneous ovarian hyperstimulation syndrome with severe undiagnosed hypothyroidism. She presented with enlarged adnexal masses, markedly elevated beta hCG and acute abdominal pain. We present three unusual cases in which ovarian “tumors” were associated with primary hypothyroidism in young women and prepubescent girls. They were all referred to us for surgery as c a s e s o f s u s p e c t e d m a l i g n a n t o v a r i a n n e o p l a s m s . Ultrasonography, thyroid function tests and tumor markers were obtained in each case. In all three cases expert radiological opinion was taken for ultrasound characteristic of the ovarian lesion. Careful investigation revealed primary hypothyroidism all three cases. They were all managed with thyroid replacement therapy, counselling and very close observation. In all three cases “tumours” completely regressed with appropriate thyroid replacement therapy and inadvertent castration was avoided in these young women.
Authors and Affiliations
Chetana Parekh, Ava Desai, Shilpa Patel, Bijal Patel, Hitesh Rajput
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