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Struma ovarii with atypical features and synchronous primary thyroid cancer: a case report and review of the literature

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To present a case of struma ovarii with a typical features and synchronous primary thyroid carcinoma and review the available literature to guide diagnosis and management of these tumors.

Methods

We present a case from our hospital of a 55-year-old woman who had an adnexal mass with features concerning for papillary thyroid carcinoma and was ultimately determined to be struma ovarii with atypical features. Subsequent thyroid imaging and biopsy revealed a primary cervical thyroid carcinoma. We performed a PubMed search of published English language articles using the search terms “malignant struma ovarii,” “metastatic struma ovarii,” “struma ovarii with malignant transformation,” “struma ovarii papillary thyroid carcinoma,” “struma ovarii follicular thyroid carcinoma,” and “struma ovarii with concurrent primary thyroid carcinoma.”

Results

Literature review included 104 studies with a total of 195 patient cases. The average age at presentation was 44.9 years. 25.1% of patients had metastatic disease at presentation, and 6.2% had synchronous primary carcinomas; all of which were located in the thyroid.

Conclusions

Thyroid carcinoma arising in struma ovarii or mature cystic teratoma should prompt clinical evaluation and imaging of the thyroid given the possibility of synchronous primaries, metastases, and recurrence.

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Acknowledgements

The authors wish to thank Ms. Jill Barr-Walker, clinical librarian, for her assistance.

Funding

There are no sources of financial support or funding to disclose.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Molly Siegel 550 16th Street, 7th Floor, Ob/Gyn Mailstop 0132, San Francisco, CA, 94143, USA

    Molly R. Siegel, Edwin A. Alvarez & Biftu M. Mengesha

  2. Department of Surgical Pathology, Zuckerburg San Francisco General Hospital and Trauma Center, San Francisco, USA

    Rebecca J. Wolsky

  3. Department of Anatomic Pathology, University of California, San Francisco, San Francisco, USA

    Rebecca J. Wolsky

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  1. Molly R. Siegel
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  2. Rebecca J. Wolsky
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  3. Edwin A. Alvarez
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  4. Biftu M. Mengesha
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Contributions

MRS project development, data collection, data analysis, manuscript writing. RJW data collection, manuscript editing. EAA project development, manuscript editing. BMM project development, manuscript editing.

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Correspondence to Molly R. Siegel.

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Informed consent was obtained from the individual participant included in this study.

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This work was performed at the Zuckerberg San Francisco General Hospital and the University of California, San Francisco.

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Siegel, M.R., Wolsky, R.J., Alvarez, E.A. et al. Struma ovarii with atypical features and synchronous primary thyroid cancer: a case report and review of the literature. Arch Gynecol Obstet 300, 1693–1707 (2019). https://doi.org/10.1007/s00404-019-05329-z

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