Pediatric Radiology History: 11 year old girl presented with increasing abdominal pain and girth. click for a larger image Imaging Findings: Axial images from and abdominal and pelvic CT scan (A) demonstrated large masses (arrow), predominantly cystic with some solid components, in the left and right abdomen. On sonography (B), the origin of these masses was felt to be from the pelvic adnexa (i.e. ovarian) with extension into the abdomen on sonography. Further history revealed symptoms of hypothyroidism. Sonography of the neck revealed a small, hypoechoic thyroid gland (C). Contrast-enhanced sagittal MR imaging of the brain revealed an enlarged pituitary gland. click for a larger image Six months following thyroid hormone replacement therapy, symptoms resolved and imaging features returned to normal. The pituitary gland returned to normal size (A) as did the ovaries (B). Diagnosis: Juvenile Hypothyroidism with Cystic Ovaries. Submitted by: Michael T. Wallach, MD Director-Pediatric Radiology TOP