Abstract
A 10 year old female presented with a 3 week history of persistent vaginal bleeding, lower abdominal pain, and generalized
fatigue. Further work-up determined that she had severe autoimmune hypothyroidism,
precocious puberty, and a large left cystic ovarian mass, consistent with Van Wyk
and Grumbach syndrome. In addition, the patient had elevated inhibin A and B levels,
which may be elevated in granulosa cell tumor. The patient was managed with thyroid
hormone replacement therapy and careful observation. Complete resolution of the ovarian
mass and interval normalization of the inhibin levels were achieved. In females with
severe primary hypothyroidism, ovarian masses, and elevated tumor markers, operative
resection may be avoided with appropriate thyroid replacement therapy and close observation.
Key words
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Article info
Publication history
Accepted:
October 31,
2012
Received in revised form:
October 31,
2012
Received:
September 14,
2012
Footnotes
☆The material contained herein has not been previously published or submitted elsewhere for publication and will not be sent to another journal until a decision is made concerning publication by the JOURNAL OF PEDIATRIC SURGERY. In addition, the authors cite no personal conflicts of interest or financial arrangements with the organizations, corporations, and/or devices detailed in this manuscript. No sources of external funding were utilized.
☆☆The undersigned authors transfer all copyright ownership of the manuscript to the JOURNAL OF PEDIATRIC SURGERY in the event the work is published. The authors warrant that the article is original, does not infringe upon any copyright or other proprietary right of any third party, is not under consideration by another journal, and has not been published previously.
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© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
