Spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma associated with primary hypothyroidism

Figure 1 Initial coronal T1-weighted image (A), T2-weighted image (B), and fat-saturated post-gadolinium T1-weighted image (C) showing a homogenous isointense, hyperintense, and enhancing pituitary mass, respectively, with suprasellar extension and mild compression of the optic chiasma.

Figure 2 Initial axial transabdominal pelvic ultrasonography (A), contrast-enhanced CT (B), and fat-saturated post-gadolinium T1-weighted image (C) showing a right ovarian cystic mass with wheel-spoke appearance. Similar results were observed in the left ovary (data not shown here).

Figure 3 Thyroid ultrasound image showing a marked heterogeneous hypoechoic gland with a small left lobe.

Figure 4 Sellar sagittal MR images with gadolinium administration before (A) and after (B) thyroid hormone replacement therapy and pelvic axial T2-weighted images before (C) and after (D) thyroid hormone replacement therapy revealed regression of the pituitary mass and ovarian cystic enlargement of both ovaries. E: A corresponding transabdominal ultrasound image after thyroid therapy demonstrating regression of both ovarian cystic masses.