Spontaneous ovarian hyperstimulation syndrome with primary hypothyroidism: Imaging a rare entity

Ilanchezhian, Subramanian; Mohan, Shubha Veppur; Ramachandran, Rajoo; Babu, Sellappan Rajamanickam

doi:10.2484/rcr.v10i1.1050

Cited by 10 publications

(10 citation statements)

References 8 publications

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“…However, it may exceptionally be spontaneous in nature, caused by the overproduction of endogenous stimulating hormones, without any external stimulation. In literature, non- iatrogenic OHSS has been described in pregnancy (especially multiple), gestational trophoblastic disease, b-hCG - secreting tumors, FSH/LH-secreting pituitary adenomas, and high levels of TSH in hypothyroidism [31 , 32] . The OHSS is characterized by the combination of massive ovarian multicystic masses and potential complication due to increased vascular permeability induced by high hormonal level [33] .…”

Section: Discussionmentioning

confidence: 99%

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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Gestational choriocarcinoma is a malignant trophoblastic tumor arising from any gestational event, even with a long latency period, generally in the reproductive female. It is associated with a high level of beta-human chorionic gonadotropin. Its primary site is usually the uterus but not all patients have a detectable lesion in this site. Regression of the primary tumor after it has metastasized is not uncommon, and one-third of cases manifest as complications of metastatic disease. In this report we present an uncommon case of gestational choriocarcinoma with lung, liver and jejunal metastases at the time of diagnosis without evidence of pelvic disease, in 34-year-old woman. The main points of interest of our case were the development of the ovarian hyperstimulation syndrome with massive multicystic ovarian enlargement induced by high level of beta-human chorionic gonadotropin and the bleeding of jejunal and liver metastases, due to the high vascularity of the tumor tissue, a condition known as “Choriocarcinoma Syndrome”. We will focus on the radiological findings of metastases, bleeding complications and ovarian hyperstimulation syndrome.

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Section: Discussionmentioning

confidence: 99%

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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“…Their details are included in Table 1 . There are reported cases of spontaneous OHSS in polycystic ovary syndrome ( 24 , 32 ), gonadotropin pituitary adenoma and pituitary enlargement ( 24 , 33–35 ), hypothyroidism ( 4 , 22 , 24 , 33 , 34 , 36–41 ), pregnancy ( 25 , 32 , 42–48 ), invasive mole or elevated human chorionic gonadotropin ( 49 , 50 ) and hypothyroidism concomitant with pregnancy ( 1 , 2 , 20 , 27 , 51–52 ). This narrative review concentrates mostly on the different clinical courses and outcomes of the seven described cases in which spontaneous OHSS was related to pregnancy, concomitant with hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous ovarian hyperstimulation syndrome in a pregnant woman with hypothyroidism: a case report

et al. 2021

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Objective To study a rare case of spontaneous ovarian hyperstimulation syndrome in a naturally conceived pregnancy associated with overt hypothyroidism. Design Case report. Setting Endocrinology private practice. Patient(s) A 32-year-old woman who was 13 weeks pregnant with bilaterally enlarged ovaries presumed to be secondary to hypothyroidism. Intervention(s) Administration of levothyroxine and titration of the dose. Main Outcome Measure(s) Regression of signs and symptoms of spontaneous ovarian hyperstimulation syndrome after 12 weeks of therapy. Result(s) The patient was diagnosed with severe hypothyroidism, as confirmed by her elevated thyroid-stimulating hormone level. Ultrasound evaluation revealed ovarian enlargement secondary to multiple contiguous cysts with anechoic content. The patient was administered levothyroxine 175 μg/day. Results of hormonal studies demonstrated thyroid function normality at week 12 after treatment. Incomplete regression of ovarian cysts was also noticed within this period. At week 37, the patient developed preeclampsia, and cesarean delivery was recommended. An 8-month postpartum ultrasound evaluation revealed complete regression of the cysts. Conclusion(s) Spontaneous ovarian hyperstimulation syndrome secondary to hypothyroidism may be the cause of ovarian enlargement, and levothyroxine replacement seems an appropriate primary therapeutic option. Proper endocrinological assessment of patients is recommended as it may avoid unfavorable outcomes.

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“…This can occur even in the absence of pregnancy and the symptoms improve with levothyroxine therapy. 15 The Type IV FSHR mutation is related to gonadotropin adenomas secreting follicle-stimulating hormone (FSH) or luteinizing hormone (LH). 7 …”

Section: Discussionmentioning

confidence: 99%

Spontaneous ovarian hyperstimulation syndrome: A report of two cases from different pathogenesis

Nwafor

Nyoyoko

2020

Niger Med J

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Spontaneous ovarian hyperstimulation syndrome (s-OHSS) is a rare finding that occurs in early pregnancy. There is a rapidly increasing ovarian size secreting vasoactive substances that lead to fluid shift into third spaces. This occurs in the absence of exogenous hormonal therapy. We present two cases of s-OHSS. A 35-year-old gravida 4 para 3 presented with complaints of progressive abdominal pain, distension, nausea, vomiting, and difficulty in breathing at 10 weeks gestation. On imaging, a singleton intrauterine gestation, enlarged ovaries containing multiple cysts, and moderate ascites were seen. Second, a 17-year-old primigravida presented with abdominal distension and pain and bleeding per vaginam following 4 months amenorrhea. A bulky uterus containing a large hyperechoic structure with multiple cystic spaces in keeping complete molar gestation and enlarged ovaries containing multiple cysts were seen on ultrasound imaging. The singleton gestation was managed successfully to term with conservative therapy tailored to clinical symptoms.

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Spontaneous ovarian hyperstimulation syndrome with primary hypothyroidism: Imaging a rare entity

Cited by 10 publications

References 8 publications

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Spontaneous ovarian hyperstimulation syndrome in a pregnant woman with hypothyroidism: a case report

Spontaneous ovarian hyperstimulation syndrome: A report of two cases from different pathogenesis

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