Obstetrics and Gynaecology, AIIMS Nagpur, Nagpur, Maharashtra, India.
Pediatrics, AIIMS Nagpur, Nagpur, Maharashtra, India.
BMJ Case Rep. 2024 Mar 8;17(3):e257409. doi: 10.1136/bcr-2023-257409.
Long-standing, overt hypothyroidism-induced bilateral multiloculated ovarian cysts represent an infrequent occurrence. Our first case, presented with bilateral complex ovarian masses, exhibited overt hypothyroidism symptoms, including lethargy, weight gain and subfertility, prompting consideration for surgical intervention. Similarly, in the second case, a girl aged 11 years with stunting, delayed bone age and academic challenges was referred for surgical exploration due to bilateral complex ovarian masses. Both cases revealed elevated thyroid-stimulating hormone levels during preoperative workup. Commencing levothyroxine replacement therapy resulted in complete regression of ovarian cysts and substantial symptom improvement within an 8-week timeframe. The third case, a previously diagnosed patient with Hashimoto's thyroiditis, benefited from the lessons gleaned in managing the initial cases, responding well to levothyroxine therapy, thereby averting the necessity for surgery in all three instances. These cases underscore the significance of considering thyroid function in the evaluation of ovarian masses and highlight the efficacy of levothyroxine replacement therapy in resolving both hypothyroidism and associated ovarian cysts, thereby obviating the need for surgical intervention.
长期存在的、明显的甲状腺功能减退症引起的双侧多房性卵巢囊肿是一种罕见的情况。我们的第一个病例表现为双侧复杂卵巢肿块，伴有明显的甲状腺功能减退症状，包括乏力、体重增加和不孕，促使考虑手术干预。同样，在第二个病例中，一名 11 岁的女孩因身材矮小、骨龄延迟和学习困难，因双侧复杂卵巢肿块而被转介进行手术探查。这两个病例在术前检查中均显示甲状腺刺激激素水平升高。开始左甲状腺素替代治疗后，卵巢囊肿完全消退，症状在 8 周内显著改善。第三个病例是一名先前诊断为桥本甲状腺炎的患者，从管理最初两个病例中吸取了经验教训，对左甲状腺素治疗反应良好，因此在所有三个病例中都避免了手术的必要性。这些病例强调了在评估卵巢肿块时考虑甲状腺功能的重要性，并突出了左甲状腺素替代治疗在解决甲状腺功能减退症和相关卵巢囊肿方面的疗效，从而避免了手术干预的需要。
