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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 89

Giant multicystic ovaries in a young girl


Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India

Date of Submission18-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Sanjay Kumar Bhadada
Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2142_19

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How to cite this article:
Pal R, Bhadada SK. Giant multicystic ovaries in a young girl. Indian J Med Res 2020;152, Suppl S1:89

How to cite this URL:
Pal R, Bhadada SK. Giant multicystic ovaries in a young girl. Indian J Med Res [serial online] 2020 [cited 2021 Sep 26];152, Suppl S1:89. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/89/316712

Patient's consent obtained to publish clinical information and images.


A 21 yr old female presented to the Endocrinology Clinic, Postgraduate Institute of Medical Education & Research, Chandigarh, India, in June 2019 with oligomenorrhoea/menorrhagia since menarche at 11 yrs of age. She had sluggish growth and poor scholastic performance since childhood. Examination revealed short stature (height SDS - 4.2), masked facies, depressed nasal bridge, hyper-telorism [Figure 1]A, dry skin, hoarse voice, goitre, delayed relaxation of deep tendon reflexes and Tanner maturity rating of A+P3B3. Investigations revealed aberrant thyroid profile (TSH=1223.0 mIU/l, T4=0.534 μg/dl, T3=0.195 ng/ml) and negative anti-TPO (thyroid peroxidase) antibody. Prolactin, follicle stimulating hormone and estradiol were elevated; basal luteinizing hormone was pre-pubertal. Ultrasonography showed giant multicystic ovaries, which was confirmed on magnetic resonance imaging [Figure 1]B and [Figure 1]C. Bone age was delayed (by 15 yr). She was diagnosed with primary hypothyroidism (auto-immune) with Van Wyk-Grumbach syndrome. Levothyroxine was started at low dose and gradually up-titrated. Ultrasound repeated after three months showed reduction in the size of ovarian cysts. Hypothyroidism should always be ruled out in girls with multicystic ovaries before subjecting them to any surgical procedures.
Figure 1: (A) Photograph of the patient showing masked facies, depressed nasal bridge and hyper-telorism suggestive of hypothyroidism. (B) T1-weighted post-contrast magnetic resonance image of the pelvis showing multiple bilateral T1-hypointense cystic areas with peripheral enhancement suggestive of multicystic ovaries (red arrowheads). The right ovary measured 6.3 × 6.4 × 6.0 cm and the left ovary measured 7.4 × 5.6 × 6.0 cm. Uterus appeared normal in size and shape (black arrowhead). (C) T2-weighted magnetic resonance image of the pelvis showing multiple bilateral T2-hyperintense cysts of varying size, suggestive of multicystic ovaries (red arrowheads).

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Conflicts of Interest: None.


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