Comparison of thyroid volumes in patients with and without endometrioma

Thyroid volume and endometriosis



endometriosis, thyroid disease, thyroid volume, ultrasonography


Background/Aim: Endometriosis is a condition characterized by endometrial tissue outside the uterus; it can lead to pelvic pain, although most cases remain asymptomatic. Abnormalities in the immune system have been hypothesized to contribute to development of ectopic endometrial tissues. Endometriosis is a chronic local inflammatory disorder associated with autoimmunity and thyroid disorders. This study aims to compare thyroid gland volumes between patients diagnosed with pathological endometrioma and those undergoing the removal of ovarian cysts for other gynecological reasons. Additionally, the study seeks to identify the coexistence of thyroid disease and determine the threshold value for thyroid volume in cases of endometriosis.

Methods: This prospective cohort study included 64 patients who met the defined inclusion criteria. Thyroid volumes were measured in women aged 18–45 with ovarian cysts before surgery. Group 1 comprised individuals with surgically planned endometrioma diagnoses later histologically confirmed after surgery. The control group (Group 2) consisted of women with similar anthropometric characteristics undergoing gynecological surgery for non-endometrioma ovarian cysts. Thyroid volume, functional thyroid hormone levels, tumor markers, and demographic data were compared between the groups.

Results: The endometrioma group exhibited a significantly higher thyroid volume. The thyroid volume variable demonstrated a diagnostic performance of 0.863 (0.771–0.956) regarding ROC-AUC in the presence of endometrioma, with a determined cutoff of 7.40. Although patients with endometrioma displayed a notably larger thyroid volume, cases of goiter were not observed. While there was no significant difference in thyroid hormones (serum TSH, T3 levels) between the groups, serum T4 was elevated in the endometrioma group, albeit within the normal laboratory range. All thyroid levels were within the normal range (euthyroid). As anticipated, serum CA-125 and CA19-9 levels were notably higher in the endometrioma group. Pathological reports did not indicate the presence of malignant cysts.

Conclusions: Patients with endometriosis experience increased thyroid volume, even without clinical signs of thyroid disease. The potential clinical interplay between thyroid diseases, thyroid volume, and endometriosis warrants consideration during patient follow-ups.


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Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, et al. Endometriosis. Endocr Rev. 2019 Aug 1;40(4):1048-79. doi: 10.1210/er.2018-00242. PMID: 30994890; PMCID: PMC6693056. DOI:

Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261-75. DOI:

Gargett CE, Schwab KE, Deane JA. Endometrial stem/progenitor cells: the first 10 years. Hum Reprod Update. 2016;22(2):137-63. DOI:

Chen LC, Hsu JW, Huang KL, Bai YM, Su TP, Li CT, et al. Risk of developing major depression and anxiety disorders among women with endometriosis: A longitudinal follow-up study. J Affect Disord. 2016;190:282-5. DOI:

Apostolopoulos NV, Alexandraki KI, Gorry A, Coker A. Association between chronic pelvic pain symptoms and the presence of endometriosis. Arch Gynecol Obstet. 2016;293(2):439-45. DOI:

Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod. 2002;17(10):2715-24. DOI:

Shigesi N, Kvaskoff M, Kirtley S, Feng Q, Fang H, Knight JC, Missmer SA, Rahmioglu N, Zondervan KT, Becker CM. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(4):486-503. DOI:

Aghajanova L, Stavreus-Evers A, Lindeberg M, Landgren BM, Sparre LS, Hovatta O. Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology. Fertil Steril. 2011;95(1):230-7. DOI:

Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31(5):702-55. DOI:

Junik R, Kozinski M, Debska-Kozinska K. Thyroid ultrasound in diabetic patients without overt thyroid disease. Acta Radiol. 2006;47(7):687-91. DOI:

Sahin SB, Ogullar S, Ural UM, Ilkkilic K, Metin Y, Ayaz T. Alterations of thyroid volume and nodular size during and after pregnancy in a severe iodine-deficient area. Clin Endocrinol (Oxf). 2014;81(5):762-8. DOI:

Choi YJ, Baek JH, Hong MJ, Lee JH. Inter-observer variation in ultrasound measurement of the volume and diameter of thyroid nodules. Korean J Radiol. 2015;16(3):560-5. DOI:

Gómez JM, Maravall FJ, Gumà A, Abós R, Soler J, Fernández-Castañer M. Thyroid volume as measured by ultrasonography in patients With type 1 diabetes mellitus without thyroid dysfunction. Horm Metab Res. 2003;35(8):486-91. DOI:

Petta CA, Arruda MS, Zantut-Wittmann DE, Benetti-Pinto CL. Thyroid autoimmunity and thyroid dysfunction in women with endometriosis. Hum Reprod. 2007;22(10):2693-7. DOI:

Yuk JS, Park EJ, Seo YS, Kim HJ, Kwon SY, Park WI. Graves Disease Is Associated With Endometriosis: A 3-Year Population-Based Cross-Sectional Study. Medicine (Baltimore). 2016;95(10):e2975. DOI:

Pasoto SG, Abrao MS, Viana VS, Bueno C, Leon EP, Bonfa E. Endometriosis and systemic lupus erythematosus: a comparative evaluation of clinical manifestations and serological autoimmune phenomena. Am J Reprod Immunol. 2005;53(2):85-93. DOI:

Şeker S, Taş İ. Determination of Thyroid Volume and Its Relation with Isthmus Thickness. Eur J Gen Med. 2010;7(2):125-9. DOI:

Darendeliler FF, Kadioğlu A, Bas F, Bundak R, Günöz H, Saka N, et al. Thyroid ultrasound in IDDM. J Pediatr Endocrinol. 1994;7(1):33-7. DOI:






Research Article

How to Cite

Seyfettinoglu S, Pekoz B, Uysal G, Kablan G. Comparison of thyroid volumes in patients with and without endometrioma: Thyroid volume and endometriosis. J Surg Med [Internet]. 2023 Aug. 20 [cited 2024 May 25];7(8):473-6. Available from: