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Hashimoto's disease in a benign cystic teratoma of the ovary

A 14-year-old schoolgirl presented in May 1990, with a %month history of abdominal swelling and discomfort. An ultrasound scan showed a cystic mass in the pelvis and an ovarian tumour was resected at laparotomy. The patient was otherwise well. Serum auto-antibodies were requested and the following results were obtained: anti-microsomal antibodies measured by gelatin particle agglutination were positive to a titre of 1600; anti-parietal cell antibodies measured by indirect immunofluorescence using mouse stomach as substrate were also positive. The presence of detectable antibody in either case is considered a positive result. Her free T.2 was 1 1 pmol/l (normal: 9-24), thyroid stimulating hormone=,.(> mU/l (normal: 0.4-4) and total T3 was 2.2 nmol/l (normal: 0.8-2.5). She had no thyroid, gastric or other symptoms. Physical examination was entirely normal. There was no family history of a thyroid or autoimmune related disorder. In the absence of symptoms, a positive family history or positive clinical findings, further investigation is thought to be unwarranted at this stage.