Abstract: Objective　To explore the clinical manifestation and laboratory test results of patients with thyroid dysfunction and malignant struma ovarii,to enhance the understanding of the disease.Methods　A patient with thyroid dysfunction and malignant struma ovarii was admitted to the Fourth Affiliated Hospital of Guangxi Medical University on 29 April 2015,the data of the case were analyzed retrospectively.To further understand coexistence of thyroid dysfunction and malignant struma ovarii by literature retrieval.Results　Struma ovarii is more common in perimenopausal women and on unilateral side，and most of them are benign,multiple metastases are rarely seen.The onset age of this case is identical with the onset age recorded in literatures,the lesion is highly malignant and multiple metastases are observed,and the case is clinically very rare because of the existence of thyroid dysfunction.Conclusion　Struma ovarii can cause hyperthyroidism,possible sources of thyroxine:high functional ovarian thyroid tissue,high functional thyroid and struma ovarii,thyroid tissue secretion combined with non functional ovarian goiter;for hyperthyroidism caused by struma ovarii,the iodine uptake rate in pelvic cavity should be high and the iodine uptake rate in the neck should be low;the diagnosis of struma ovarii combined with hyperthyroidism is relatively difficult,the disease always is paid more attention to due to repeated recurrence of hyperthyroidism,non functional struma ovarii is more likely to cause missed diagnosis;functional ovarian thyroid is similar to ectopic thyroid gland hyperactive adenoma,and can secrete thyroid hormone,thus can inhibit thyroid function,but struma ovarii secrets triiodothyronine（T3） mainly,the abnormal thyroid function performance such as increased levels of TT3 and FT3,and decreased levels of TSH,TT4 and FT4 may exist,all of these findings warrant further research.

Key words: Struma ovarii, Hyperthyroidism, Case reports, Historical article

摘要： 目的　分析恶性卵巢甲状腺肿合并甲状腺功能异常患者的临床表现、实验室检查结果，进一步加深对本病的认识。方法　回顾性分析广西医科大学第四附属医院2015-04-29收住的1例恶性卵巢甲状腺肿合并甲状腺功能异常的罕见病例，同时通过检索卵巢甲状腺肿合并甲状腺功能异常的文献，进一步了解并认识此疾病。结果　卵巢甲状腺肿多见于围绝经期女性，单侧为主，一般为良性，恶性少见，全身多处转移更罕见，本例患者发病年龄与文献相符，表现为高度恶性并全身多处转移，同时合并甲状腺功能异常，属临床极罕见病例。结论　卵巢甲状腺肿可以导致甲状腺功能亢进，其产生的甲状腺素可能来源于：高功能卵巢甲状腺组织、高功能甲状腺和卵巢甲状腺组织同时存在、甲状腺组织分泌合并无功能卵巢甲状腺肿；由卵巢甲状腺肿导致的甲状腺功能亢进应该表现为盆腔摄碘率高而颈部摄碘率低；卵巢甲状腺肿合并甲状腺功能亢进的诊断较困难，多因反复复发的甲状腺功能亢进而引起重视，无功能性卵巢甲状腺肿更易引起漏诊；功能性卵巢甲状腺类似于异位甲状腺高功能腺瘤，其可分泌甲状腺激素，从而抑制甲状腺本身功能，但卵巢甲状腺肿以分泌三碘甲状腺原氨酸（T3）为主，可出现总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸（FT3）水平升高，促甲状腺素（TSH）、总甲状腺素（TT4）、游离甲状腺素（FT4）水平降低等异常甲状腺功能表现，但还需进一步研究证实。

关键词: 卵巢甲状腺肿, 甲状腺功能亢进症, 病例报告, 历史文献