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Hypothyroidism due to Hashimoto thyroiditis post struma ovarii excision.
Vera N Amareen1, Fares H Haddad, Nabih S Al-Kaisi
1Department of Obstetric and Gynecology, King Hussein Medical Center, Amman, Jordan.
Saudi Medical Journal
|July 6, 2004
Summary
This study details a rare case of Hashimoto thyroiditis (HT) developing after struma ovarii resection. Post-surgery, the patient became hypothyroid, indicating the struma ovarii tumor likely compensated for thyroid function preoperatively.
Area of Science:
- Endocrinology
- Gynecologic Oncology
- Pathology
Background:
- Struma ovarii, a rare ovarian teratoma, can secrete thyroid hormones and potentially cause hyperthyroidism.
- The co-occurrence of struma ovarii and Hashimoto thyroiditis (HT) is exceptionally rare, with limited documented cases.
- Understanding the interplay between ovarian teratomas and autoimmune thyroid disease is crucial for diagnosis and management.
Observation:
- A patient presented with a struma ovarii tumor.
- Following surgical resection of the struma ovarii, the patient developed overt hypothyroidism.
- Laboratory tests revealed elevated thyroid-stimulating hormone (TSH) and low thyroxine levels, with positive thyroid peroxidase antibodies.
Findings:
- The patient exhibited symptoms and biochemical evidence of hypothyroidism post-struma ovarii removal.
- Positive thyroid peroxidase antibodies confirmed the presence of Hashimoto thyroiditis.
- Levothyroxine replacement therapy effectively resolved the hypothyroid state.
Implications:
- This case suggests that struma ovarii may have masked underlying hypothyroidism or compensated for thyroid hormone deficiency preoperatively.
- The development of HT after resection highlights the complex interactions between ovarian tumors and thyroid function.
- Further research into the immunological and hormonal interplay in such rare cases is warranted to improve patient care.