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Case Report
Hyperfunctioning benign struma ovarii in a young patient with Graves’ disease: Challenges in fertility-sparing management
1 Resident, Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore
2 Senior Consultant, Department of Internal Medicine, Singapore General Hospital, Singapore
3 Senior Consultant, Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore
Address correspondence to:
Lee Shi Hui
Academia, Level 5, 20 College Rd, Singapore 169856,
Singapore
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Article ID: 100059Z08LH2020
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Lee SH, Qin Y, Lim SK. Hyperfunctioning benign struma ovarii in a young patient with Graves’ disease: Challenges in fertility-sparing management. J Case Rep Images Obstet Gynecol 2020;6:100059Z08LH2020.ABSTRACT
Introduction: Concomitant Graves’ disease with struma ovarii is a rare condition, with 18 cases reported to date. Preoperative diagnosis of struma ovarii is challenging due to nonspecific imaging features. Many patients are taken for extensive staging laparotomy in view of concerns of ovarian malignancy, however, benign struma ovarii can be treated satisfactorily by cystectomy or oophorectomy.
Case Report: We present a case of a 33-year-old Chinese lady with known Graves’ disease, who was incidentally found to have a complex solid-cystic right ovarian cyst on pelvic ultrasound. Magnetic resonance imaging of the pelvis was suspicious for primary epithelial ovarian neoplasm. In view of her young age, she was keen for fertility-sparing surgery. She underwent laparotomy ovarian cystectomy with frozen section, which showed benign struma ovarii. Postoperatively, she remained clinically euthyroid without further medical treatment. Postoperative technetium 99m showed no residual ectopic thyroid tissue in the pelvis.
Conclusion: This could be the sixth case in the world where conservative surgery was used in a patient with concomitant Graves’ disease with struma ovarii.
Keywords: Fertility-sparing surgery, Functioning struma ovarii, Graves’ disease
SUPPORTING INFORMATION
Acknowledgments
We thank Dr. Wong Shing Lih from Department of Pathology, Singapore General Hospital, for his help in obtaining the histopathological slides for this patient.
Author ContributionsLee Shi Hui - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Qin Yan - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Lim Shau Khng - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Lee Shi Hui et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
