title: Ignored adult primary hypothyroidism presenting chiefly with persistent ovarian cysts: a need for increased awareness.
abstract: BACKGROUND
  Ovarian cysts are a common cause for gynecological surgery. However, some cysts are a direct result of endocrine disorders and do not require surgery. This report describes an unusual case in which persistent ovarian cysts are associated with primary hypothyroidism in a young woman. The data were collected by history-taking, physical examination, laboratory tests, ultrasound, magnetic resonance imaging and a histo-pathological study. In addition, the exons of the gene encoding the human follicle-stimulating hormone receptor were sequenced.
  
  
  CONCLUSIONS
  The patient had markedly elevated levels of thyroid-stimulating hormone and follicle-stimulating hormone and an enlarged pituitary gland. After treatment with thyroid hormone replacement, regression of the enlarged pituitary and the ovarian cysts was observed. The possible mechanisms of the pathophysiology are discussed below.
  
  
  CONCLUSIONS
  It is necessary to consider hypothyroidism and other endocrine disorders in the differential diagnosis of adult patients with ovarian multiple cyst formation in order to prevent inadvertent ovarian surgery.
authors.affiliation: Department of Obstetrics & Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Shu
authors.forename: Lili
authors.initials: L
authors.lastname: Xing
authors.forename: Lingyan
authors.initials: L
authors.lastname: Zhang
authors.forename: Suhua
authors.initials: S
authors.lastname: Fang
authors.forename: Hefeng
authors.initials: H
authors.lastname: Huang
mesh_terms: D000328:Adult; D003409:Congenital Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D010048:Ovarian Cysts / Q000175:diagnosis / Q000209:etiology*; D011962:Receptors, FSH / Q000737:chemistry / Q000235:genetics; D012008:Recurrence; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011962:Receptors, FSH; D013974:Thyroxine