PDF(Pubmed)
Abstract：
A 19-year-old girl with a short stature and presenting low intelligence quotient, illegible speech, and a greatly distended abdomen was seen at the gynecological outpatient department. She underwent investigation and was found to have large abdominopelvic multicystic ovaries with no malignant features and CA125 levels within the normal range for premenopausal women. Her thyroid-stimulating hormone (TSH) was markedly elevated. She received a diagnosis of untreated severe hypothyroidism with benign giant ovarian cysts, posing a grave risk of cyst rupture and imminent complications. The parents were counseled, and they accepted the risk, agreeing to conservative therapy. Levothyroxine replacement therapy was initiated, and after one month, her TSH levels normalized. Follow-up ultrasonography after one month of her therapy revealed a marked decrease in ovarian cyst size. Thyroid replacement therapy was continued, and at the end of three months, the cysts disappeared, and the ovaries, much smaller, showed polycystic ovarian morphology. Careful analysis of clinical signs, investigations, and appropriate therapy helped avoid unnecessary surgery.
摘要：
一个身材矮小、智商低的19岁女孩，难以辨认的演讲，在妇科门诊部看到腹部大大扩张。她接受了调查，发现有较大的腹肾盂多囊性卵巢，无恶性特征，绝经前妇女的CA125水平在正常范围内。她的促甲状腺激素（TSH）显着升高。她被诊断为未经治疗的严重甲状腺功能减退伴良性巨大卵巢囊肿，构成囊肿破裂和迫在眉睫的并发症的严重风险。父母得到了建议，他们接受了风险，同意保守治疗.左甲状腺素替代疗法开始，一个月后,她的TSH水平恢复正常.治疗一个月后的随访超声检查显示卵巢囊肿大小明显减小。继续进行甲状腺替代治疗，三个月后,囊肿消失了,和卵巢,小得多，卵巢形态多囊。仔细分析临床体征，调查,适当的治疗有助于避免不必要的手术。
