Coexistence of struma ovarii and Graves' disease

A 30-year-old woman with hyperthyroidism due to coexisting Graves' disease and struma ovarii is described. Physical examination revealed a diffusely enlarged thyroid and an abdominal mass. CT scan of the abdomen showed a 25-cm predominantly cystic right ovarian mass. 123I uptake and scan showed 75% thyroid uptake at 4 h and a focus of intense uptake in the left upper quadrant of the abdomen. Preoperative treatment for the hyperthyroidism included propylthiouracil, propranolol, and ipodate. Surgery was performed and pathologic examination of the ovarian mass revealed struma ovarii.