Case of ovarian cancer in a woman with undiagnosed Graves’ d
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Epithelial ovarian cancer (OC) is a leading cause of death among females , due in part to challenges of diagnosis in the early stages of the disease. One such population may be females with hyperthyroidism, as epidemiologic studies have shown an association between this condition and OC. This article presents a case of a female with OC and Graves’ disease to highlight the potential significance of this association.

Case Presentation
A 50-year-old female without significant past medical history presented to an emergency department with chest pain and shortness of breath and was found to have a pulmonary embolism. One month later, she presented again to the emergency department with abdominal pain and distension, and a CT scan revealed a 12 × 10 × 11 cm pelvic mass with large-volume ascites and evidence of carcinomatosis. She was diagnosed with stage III high-grade serous OC and underwent surgical resection and 6 cycles of intravenous and intraperitoneal cisplatin and taxol.

Four months after completion of therapy, she reported insomnia and jitteriness that had been present for nearly 10 years and managed with as-needed benzodiazepines. Laboratory studies revealed an undetectable TSH and a free T4 level of 4.4 ng/dL, consistent with a diagnosis of hyperthyroidism. Thyroid-stimulating immunoglobulin was found to be 531% of baseline (normal range: <140%). This confirmed a diagnosis of Graves’ disease...

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