Asymmetrical Ovarian Enlargement: Caught Timely Before the Cut!

J Pediatr Adolesc Gynecol. 2015 Jun;28(3):e83-5. doi: 10.1016/j.jpag.2014.07.004. Epub 2014 Jul 21.

Abstract

Background: Van Wyk-Grumbach syndrome is a rare complication of prolonged untreated primary hypothyroidism characterized by precocious puberty and enlarged multicystic ovaries. High index of suspicion and timely diagnosis can prevent unnecessary surgical procedures because this condition can be reversed with thyroid hormone supplementation.

Case: A 12-year-old girl underwent abdominal ultrasonography for recurrent abdominal pain, which showed bilateral asymmetrical enlargement of ovaries. Ovarian tumor markers were negative. Subsequent evaluation revealed severe hypothyroidism. Patient was started on levothyroxine and both ovaries showed regression to normal volume within 1 year of normalizing thyroid function tests.

Summary and conclusion: Prompt and adequate medical management with levothyroxine can completely reverse ovarian enlargement associated with hypothyroidism.

Keywords: Hypothyroidism; Ovarian enlargement; Van Wyk Graumbach Syndrome.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Child
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Hypothyroidism / complications*
  • Hypothyroidism / diagnosis*
  • Hypothyroidism / drug therapy
  • Ovarian Cysts / etiology*
  • Puberty, Precocious / etiology*
  • Syndrome
  • Thyroxine / therapeutic use

Substances

  • Thyroxine