Understanding Struma Ovarii and Its Connection to Thyroid Nodules
Hello everyone, I am a 42-year-old woman who recently encountered a concerning health situation. Earlier this year in March, I was admitted to the ICU due to diabetic ketoacidosis (DKA), and that was when a tumor was found in my ovary. In June, I underwent a total abdominal hysterectomy along with a bilateral salpingo-oophorectomy because of this ovarian mass. As a result, I am now adjusting to surgical menopause while recuperating at home. Prior to the surgery, I had a benign thyroid nodule diagnosed as a colloid goiter, after having a biopsy in 2022, and my thyroid function was normal. Additionally, I manage type 2 diabetes. Now, two weeks after my operation, I’m facing a set of symptoms that are concerning: - Pain and swelling in the thyroid region, which seems to be more sensitive and inflamed compared to before. - Tenderness in my breasts, despite my OB-GYN indicating this shouldn’t occur after menopause. - A general feeling of inflammation and discomfort throughout my body. Though I am not experiencing fever or visible redness, it feels as if my entire system is responding to something. I have consulted with several doctors, yet I feel like the responses are not addressing my holistic situation that includes my thyroid, hormones, breast health, and potential immune responses. The biopsy of the ovarian mass confirmed it is benign (classified as struma ovarii), and my OB-GYN assured me that it is unrelated to my thyroid nodule. Could this situation be attributed to: - A potential flare of thyroiditis caused by surgical stress? - A sudden drop in hormones due to surgical menopause? - An inflammatory reaction resulting from the operation? - Breast pain stemming from lingering hormonal adjustments? - Or possibly something more serious? I would be grateful for any insights from medical professionals or individuals who have faced similar experiences. What diagnostic tests should I consider? What specialists should I reach out to next—an endocrinologist or an ENT for the nodule? My goal is to uncover the underlying cause rather than to simply undergo another procedure. I’ve heard that growths can recur in other organs or areas if the root cause remains unidentified. Thank you for taking the time to read my post and for any assistance you can provide as I navigate through this. 🙏
Answers (1)
7/2/2025, 11:01:32 AM
OpenHealth AI
It sounds like you're going through a challenging time with multiple interconnected health concerns. Your symptoms and history suggest several possible explanations for what you’re experiencing, including hormonal changes after surgery, inflammation due to stress, and potential thyroid issues. Let’s break this down.
Main Points:
- Symptoms Post-Surgery: Your thyroid tenderness, breast pain, and overall discomfort could be linked to surgical stress, hormonal shifts, or inflammation.
- Examination of Hormonal Changes: Sudden surgical menopause can lead to a variety of symptoms due to changes in estrogen levels.
- Potential Thyroiditis or Inflammation: Stress from surgery might exacerbate any underlying thyroid issues or lead to new ones.
Explanation:
- Surgical Stress and Thyroiditis: The stress of surgery can sometimes trigger thyroiditis, an inflammation of the thyroid, which might explain the pain and swelling you’re experiencing.
- Hormonal Changes: After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, your body stops producing estrogen, leading to menopausal symptoms, including breast tenderness. This can also contribute to systemic feelings of discomfort.
- Inflammation: Surgery can cause generalized inflammation, possibly intensifying any autoimmune responses, or leading to localized issues like tenderness in the thyroid area.
- Breast Pain: Hormonal adjustments can also lead to breast sensitivity, which can still occur post-menopause.
Next Steps:
- Keep a Symptom Journal: Document your symptoms daily, including pain levels, any new symptoms, and possible triggers. This will help your healthcare team in diagnosing your condition.
- Consult Specialists: Reach out to:
- An Endocrinologist: They can evaluate your thyroid function again, check for thyroiditis, and discuss any links with your breast symptoms.
- A Gynecologist or Reproductive Endocrinologist: They can help manage menopausal symptoms and assess your breast health further.
- Diagnostic Tests:
- Thyroid Function Tests: To assess your TSH, T3, and T4 levels again.
- Thyroid Ultrasound: To evaluate any changes in your thyroid nodules or possible signs of inflammation.
- Hormonal Panel: To measure hormone levels and assess how your body is adjusting post-surgery.
- Consider Nutritional Support: Ensure you are eating a balanced diet rich in anti-inflammatory foods (like fruits, vegetables, whole grains, and healthy fats) to support your recovery.
Remember, it's essential to communicate openly with your healthcare providers about your symptoms and concerns. It’s understandable to feel overwhelmed, but taking these structured steps can help you clarify your situation and drive forward in addressing your health comprehensively. You are not alone in this, and it’s good to seek support.
Related Questions
Battling Chronic Nausea and Vomiting for Over Two Years
For the past two years, I (age 26, female) have been enduring an incredibly challenging health situation. I experience intense nausea daily and find myself vomiting numerous times, with almost nothing providing relief. To provide some background, I’m from West Texas and I currently weigh around 190 pounds, standing at 5’7”. Initially, my weight was about 211 pounds when these symptoms began, and it fluctuates frequently between 190 and 225 pounds. I engage in vaping and consume THC. Previously diagnosed with hypothyroidism, my condition seemingly resolved, according to my healthcare providers. Additionally, I have polycystic ovarian syndrome (PCOS). I have consistently faced irregular bowel movements, with stools that are loose and sometimes appear to have mucus. Compounding my struggles, I've also suffered from migraines. I have had an IUD for over five years, experiencing two insertions of the Kyleena device. In December 2022, my battle with health took a severe turn when I was diagnosed with stage 4 Hodgkin’s Lymphoma, requiring chemotherapy treatment, specifically AVBD (Apologies for not recalling the exact medication names). By July 2023, I had fortunately achieved remission. However, after reaching remission, my vomiting worsened, transforming from primarily white foam to a mixture of 80% bile, any food I attempt to consume, and still white foam. This intense vomiting, accompanied by significant pain in my upper back, escalated to more than eight episodes daily by November 2023. At that time, THC seemed to be the only avenue for me to retain any food. During this tumultuous period, I consulted various doctors who, after confirming I wasn’t pregnant, attributed my symptoms to Cannabinoid Hyperemesis Syndrome (CHS). Immediately, I ceased THC consumption for over six months, yet the vomiting continued unabated. Each time, doctors would prescribe ondansetron, regardless of my claims that it provided no relief. I experimented with various diets recommended by medical professionals, but there were no improvements in my condition. Eventually, I obtained a referral to a gastroenterologist who intended to perform an endoscopy. However, the procedure was prohibitively expensive even with insurance, and thus was never conducted. This doctor also ordered blood tests to rule out several gastrointestinal disorders, such as Crohn's disease, Irritable Bowel Syndrome (IBS), and gluten sensitivity, but all results came back normal. Afterward, I had another appointment with a different gastroenterologist, but the doctor failed to meet with me. Instead, a nurse informed me that the doctor had merely recommended promethazine without conducting any tests or scheduling further visits. When I mentioned the possibility of gallbladder issues, the doctor laughed dismissively at my suggestion. Discussing my situation with my oncologist, he suggested that my heightened sensitivity to food odors stemmed from my chemotherapy experiences while I was working in fast food. While food smells indeed affect me, I'm primarily triggered by medical scents such as rubbing alcohol and cleaning agents. This ongoing ordeal has been overwhelmingly distressing. I now experience episodes of vomiting accompanied by bright red blood, presumably due to a throat tear. When I first encountered this troubling symptom, I consulted a doctor who appeared unfazed and prescribed a promethazine suppository, which does help but makes me extremely drowsy. My nausea persists nearly around the clock, often feeling as if there’s a heaviness in the upper part of my abdomen. I frequent urgent care facilities when my symptoms intensify, only to be met with minimal assistance since this is a chronic issue. Currently, I lack a primary care physician. Whenever I sought one, I encountered skepticism regarding my condition, with some healthcare professionals implying that I was exaggerating my symptoms. Though many physicians who do take my situation seriously seem baffled, I've lost count of the diverse medical experts I've consulted about these ongoing issues. If anyone has insight or suggestions, I would genuinely appreciate it. I can share my latest bloodwork results if that would be helpful—just let me know!
Strange Stomach Sensation Leading to Waking Up
Greetings. I'm a 36-year-old male, standing at 172 centimeters and weighing 90 kilograms. I don't take any medications, nor do I smoke. I've been living with diastasis recti for several years now, and I may also have irritable bowel syndrome (IBS). Additionally, I deal with fatty liver and kidney stones, though I assume these last two conditions are not related to my current concern. Occasionally, I experience a peculiar sensation that jolts me awake; it feels like a quick pulsing in my stomach. I’ve noticed it tends to affect the left side when I’m lying on my left side and the right side when on my right. Remarkably, it can occur even when I’m on my back. This strange feeling often escalates into a surge that fully rouses me. Alongside this, I sometimes feel prickling sensations throughout my body and fleeting lightheadedness. When this sensation disturbs my sleep while I’m turned to my side, shifting onto my back or the opposite side might alleviate it, but not always. In instances where I awaken while lying on my back, I discovered that gently pressing my hands on either side of my stomach can help, as can rising to a sitting or standing position. However, during my last two episodes—one a couple of weeks ago and another tonight—those techniques weren’t effective right away, which made me feel a bit anxious, prompting me to seek advice. Does anyone have insight into what might be going on? By the way, I’ve undergone routine ultrasound examinations of my abdomen by two different physicians during check-ups, both of whom assured me that everything appears normal, including my abdominal aorta and internal organs. They didn’t identify any issues at that time.
Understanding Tuberculosis Exposure Risk
A 26-year-old male, who neither drinks alcohol nor smokes, seeks to understand the implications of exposure to tuberculosis (TB). As an anesthesia technician, I became concerned after I encountered a TB-positive patient about a month ago. I had to enter the patient’s room several times to perform blood gas tests. On my first entry, I mistakenly wore my N95 mask incorrectly due to the hectic nature of attending to multiple rooms. From my research, it appears that TB is quite transmissible; direct exposure can pose a serious risk of infection. Transmission usually requires prolonged contact with an infected individual, particularly in a close or face-to-face setting. In this case, the patient was lying face down and appeared to be sleeping when I entered. I have already undergone testing for TB, but I am eager to deepen my understanding of the risks involved in these situations.
24M | Unexplained Fainting Incident
**Note:** I previously shared this story, but it was inexplicably removed. I’m a 24-year-old male without any medical diagnosis or prescription medications. While I do consume alcohol occasionally, I hadn’t been drinking before this happened. Around 3 a.m., I got up from bed to use the restroom. As soon as I began to urinate, I suddenly felt a wave of dizziness. The next moment I was aware of was regaining consciousness in the bathtub, startled awake by the sensation of something dripping on me—only to discover it was my own blood. This was my first experience with fainting. When I came to, confusion set in. I was disoriented and couldn’t comprehend why I was being dripped on while in what I thought was my “bed.” Strangely, I also imagined that I was lying on a collection of marbles (which I actually don’t own)—this turned out to be the shattered glass of my shower door lying around me. I’m uncertain whether I lost consciousness first and then fell, or if the fall caused my brief blackout. It took me a few moments to understand why I was in the bathroom at all. I’m not sure how long I was out; I only remember it was around 3 in the morning when I initially got up, and about the same time when I regained consciousness. I dialed 911, and the ambulance arrived promptly. They checked my vitals, performed an EKG and measured my blood sugar, finding nothing unusual. At the emergency room, they repeated the vital checks, conducted a CT scan, drew blood, and took x-rays—yet still no abnormalities were detected. I had several cuts on my face and left arm (curiously, this is the arm that would have been turned away from the door), along with bruising around my ribs. Since the incident, I’ve been suffering from headaches and pain in my ribs. I received stitches on both my face and arm. The nurse suggested I could have stronger pain relief, but I opted for just Toradol. They eventually discharged me, stating, "We’re unsure what caused this, but return if it happens again." What might have triggered such an incident? How can I safeguard against it reoccurring if they remain uncertain about the cause?
Challenges with Appetite and Discomfort While Eating — Difficulty in Gaining Weight
As an 18-year-old male, I find that I become satisfied after consuming rather minimal amounts of food. This situation presents a considerable challenge, particularly since I only need to have a standard breakfast, lunch, or dinner to feel completely satiated for the remainder of the day. My goal of increasing my weight has made this issue even more complicated. When I limit myself to one meal per day, I often face weight loss or an uncomfortable sensation of fullness that leaves me feeling sluggish. Opting for two meals makes me feel excessively bloated, distracting me from my daily responsibilities. Moreover, I suffer from an unusual issue with my throat, where almost any food I consume causes discomfort, as detailed in the list below. I have contemplated focusing on having just lunch while continuing my weightlifting regimen to maintain my current weight and gradually build muscle. What advice could you offer? Could there be an underlying cause for these symptoms? Lastly, would it be wise for me to consult a healthcare professional? Foods That Cause Discomfort: Bread, flour, pizza, fruits, sugary or starchy items, seed oils, chips, and essentially everything else. Foods That Are Tolerable: Rice, salads, chicken, fish, and vegetables. Overall Symptoms Include: * Quick satiety after normal meals * Challenges in gaining weight * Bloated and lethargic sensations when consuming more than one meal * Persistent throat sensitivity to a wide variety of foods