Padmanaban Preethi, Nylen Eric, Burman Kenneth, Sen Sabyasachi
Division of Endocrinology, Department of Medicine, The George Washington University, Washington, DC, USA.
Department of Endocrinology, Washington DC VA Medical Center, Washington DC, DC, USA.
BMJ Case Rep. 2021 Apr 15;14(4):e240924. doi: 10.1136/bcr-2020-240924.
We report a case of 34-year-old clinically asymptomatic woman who had been followed for 6 years for hyperthyroidism with thyroid stimulating hormone <0.006 uIU/mL, free T4 1.98 ng/mL, free T3 5.3 pg/mL, elevated thyroid stimulating immunoglobulin 1.70 IU/L, thyroid peroxidase antibody 38 IU/mL and thyroglobulin antibody 9.3 IU/mL. Radioiodine thyroid scan showed minimal uptake in both thyroid lobes (24-hour uptake was 0.3%). She subsequently underwent evaluation for lower abdominal pain and menstrual irregularities, which revealed a large left ovarian cyst measuring 15.9 cm × 10.8 cm × 13.2 cm and right-sided ovarian cyst measuring 2.7 cm × 3.3 cm × 3.5 cm. Laparoscopic bilateral ovarian cystectomy was performed and the final pathology revealed struma ovarii of the left ovarian cyst with the entire ovarian tumour made up of benign thyroid tissue. Thyroid function tests performed 3 months after surgical removal of struma ovarii showed euthyroidism. We present a rare case with detailed laboratory and immunological data before and after ovarian extirpation with resolution of hyperthyroidism associated with functional struma ovarii.
我们报告一例34岁临床无症状女性，因甲状腺功能亢进接受随访6年，促甲状腺激素<0.006 uIU/mL，游离T4 1.98 ng/mL，游离T3 5.3 pg/mL，甲状腺刺激免疫球蛋白升高至1.70 IU/L，甲状腺过氧化物酶抗体38 IU/mL，甲状腺球蛋白抗体9.3 IU/mL。放射性碘甲状腺扫描显示双侧甲状腺叶摄取极少（24小时摄取率为0.3%）。她随后因下腹部疼痛和月经不调接受评估，结果发现左侧有一个大卵巢囊肿，大小为15.9 cm×10.8 cm×13.2 cm，右侧有一个卵巢囊肿，大小为2.7 cm×3.3 cm×3.5 cm。进行了腹腔镜双侧卵巢囊肿切除术，最终病理显示左侧卵巢囊肿为卵巢甲状腺肿，整个卵巢肿瘤由良性甲状腺组织构成。切除卵巢甲状腺肿手术后3个月进行的甲状腺功能测试显示甲状腺功能正常。我们呈现了这一罕见病例，并提供了卵巢切除前后详细的实验室和免疫学数据，以及与功能性卵巢甲状腺肿相关的甲状腺功能亢进症得到缓解的情况。
