# Huge Bilateral Ovarian Cysts With Concurrent Hypothyroidism: A Case Report

## TL;DR

A young girl with hypothyroidism and large ovarian cysts improved significantly after thyroid hormone therapy, avoiding surgery.

## Contribution

Demonstrates successful conservative treatment of giant ovarian cysts linked to untreated hypothyroidism.

## Key findings

- Thyroid hormone replacement normalized TSH levels within a month.
- Ovarian cysts significantly reduced in size after one month and disappeared after three months of therapy.
- Conservative treatment avoided surgery and resolved complications.

## 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.