Z Frysak1, J Schovanek1, M Halenka1, I Metelkova2, M Duskova3, D Karasek1. 1. Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc - Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Olomouc, Czech Republic. 2. Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc - Department of Nuclear Medicine - Olomouc, Czech Republic. 3. Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc - Department of Clinical and Molecular Pathology, Olomouc, Czech Republic.
Abstract
INTRODUCTION: Thyroid tissue ectopically located in the ovary can be reported accidentally after adnexectomy, but as a primary cause of hyperthyroidism this diagnosis is rare. The clinical search for a functional ectopic thyroid tissue requires intense clinical focus and a multidisciplinary approach. CASE DESCRIPTION: This case report demonstrates a patient with a history of Graves' disease who had undergone thyroidectomy combined with postoperative 131I radioablation. Despite the previous treatment, she developed an outburst of hyperthyroidism ten years later. Only very close follow-up enabled us to disclose the right condition. The ovarian source of thyroid hormone production was removed by laparoscopic adnexectomy and a right sided benign ovarian struma was confirmed. CONCLUSION: Most patients treated by thyroidectomy and radioiodine do not require extended periods of follow-up or postoperative investigations, but when the clinical or laboratory signs change, clinicians should be prepared to perform the necessary re-evaluation in order to provide the best care.
INTRODUCTION: Thyroid tissue ectopically located in the ovary can be reported accidentally after adnexectomy, but as a primary cause of hyperthyroidism this diagnosis is rare. The clinical search for a functional ectopic thyroid tissue requires intense clinical focus and a multidisciplinary approach. CASE DESCRIPTION: This case report demonstrates a patient with a history of Graves' disease who had undergone thyroidectomy combined with postoperative 131I radioablation. Despite the previous treatment, she developed an outburst of hyperthyroidism ten years later. Only very close follow-up enabled us to disclose the right condition. The ovarian source of thyroid hormone production was removed by laparoscopic adnexectomy and a right sided benign ovarian struma was confirmed. CONCLUSION: Most patients treated by thyroidectomy and radioiodine do not require extended periods of follow-up or postoperative investigations, but when the clinical or laboratory signs change, clinicians should be prepared to perform the necessary re-evaluation in order to provide the best care.
Authors: Twyla B Bartel; Malik E Juweid; Thomas O'dorisio; William Sivitz; Patricia Kirby Journal: J Clin Endocrinol Metab Date: 2005-06 Impact factor: 5.958
Authors: Erin F Wolff; Marybeth Hughes; Maria J Merino; James C Reynolds; Jeremy L Davis; Craig S Cochran; Francesco S Celi Journal: Thyroid Date: 2010-09 Impact factor: 6.568