Interdisciplinary Care and a Focus on Fertility Preservation When Multi-cystic Ovaries Cause Ovarian Torsion: A Case of a 9-year-old Girl with Severe, Undiagnosed Hypothyroidism - 04/12/20
, Christine M. Pennesi, MD 2, Monica W. Rosen, MD 2, Adrian Araya, MD 3, Adam Baruch, MD 1, Meghan A. Arnold, MD 4, Elisabeth H. Quint, MD 2Abstract |
Background |
Ovarian torsion can occur in Van Wyk Grumbach syndrome, a disorder characterized by severe primary hypothyroidism and ovarian enlargement. To date, all documented cases of torsion in this setting describe oophorectomy, which has significant hormonal and fertility implications.
Case |
A 9-year-old pubertal girl presented to the emergency room with abdominal pain. Magnetic resonance imaging demonstrated bilateral, multi-cystic ovaries. Operative laparoscopy confirmed unilateral adnexal torsion, and detorsion without oophorectomy was accomplished. Postoperative laboratory tests revealed severe primary hypothyroidism. Ovarian size was reduced with hormone replacement therapy.
Summary and Conclusion |
This case demonstrates that prompt interdisciplinary intervention and awareness of severe hypothyroidism as a cause of ovarian torsion related to enlarged, multi-cystic ovaries may reduce the rate of oophorectomy, allowing preservation of pediatric patients’ future fertility, and reducing morbidity postoperatively through prompt, long-term thyroid supplementation.
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| The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. |
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| This work was accepted for scientific poster presentation at the North American Society for Pediatric and Adolescent Gynecology Annual Clinical & Research Meeting, Grapevine, Texas, April 4, 2020 (conference canceled due to COVID-19). |
Vol 33 - N° 6
P. 723-726 - décembre 2020 Retour au numéro
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