Recurring Acute Abdomen, Ovarian Cyst and Hypothyroidism

From the Woman Clinic & Centre for Medical Education & Research. Correspondence to : Prof. Kamal Buckshee, Former Prof. & Head Dept. of Obst & Gynae , AIIMS, 46, Sec 15 A, NOIDA 201301, UP, India Abstract Spontaneous ovarian hyperstimulation, large ovarian cyst and multicystic ovaries associated with primary hypothyroidism is infrequently reported and not widely recognized in gynaecologic literature. We report a case of a 15 year old girl who had an acute abdomen and emergency laparotomy revealed bilaterally enlarged ovaries, a large ovarian cyst with torsion in the right ovary and ascites. Thus right adnexa was removed. At that time thyroid dysfunction was neither suspected nor investigated. Five years later patient again developed acute abdomen with a large cyst in the remaining left ovary. Thyroid evaluation at this point of time indicated profound hypothyroidism. Treatment with thyroxin resulted in marked clinical improvement and resolution of the ovarian cyst thus highlighting the significance of assessing thyroid function tests in young girls with above clinical profile. Surgery is indicated if there is a complication or failure to medical treatment. We conclude that severe hypothyroidism was probably responsible for various ovarian disorders that might have resulted from the effects of an excess amount of TSH on immature ovaries.