Abstract
Background A 25-year-old woman presented to her gynecologist with pelvic pain. Pelvic ultrasonography showed a 9 cm left ovarian mass. The patient underwent left oophorectomy, omental biopsy, and lymph node sampling. The ovarian mass proved to be a struma ovarii with numerous microscopic foci of papillary thyroid carcinoma. The patient had no symptoms of hyperthyroidism, and her thyroid function and serum thyroglobulin levels were normal.
Investigations Investigations included a pelvic ultrasound scan, histological examination of the ovarian mass and omental nodules, and lymph node sampling.
Diagnosis Malignant struma ovarii.
Management The patient was referred to an endocrinology clinic for further investigations. Serum levels of TSH, thyroglobulin and thyroglobulin antibodies were measured. In addition, the patient underwent thyroid ultrasonography, which showed a 1 cm nodule that proved benign on biopsy. She was treated with thyroxine to reduce TSH secretion. Follow-up pelvic ultrasonography 1 year later showed no evidence of recurrent disease, and her serum thyroglobulin levels remained normal.
References
Medeiros F et al. (2006) Germ cell tumors of the ovary. In: Diagnostic Gynecologic and Obstetric Pathology, 920–921 (eds Crum CP and Lee KR) Philadelphia: Elsevier Saunders
Devaney K et al. (1993) Proliferative and histologically malignant struma ovarii: a clinicopathologic study of 54 cases. Int J Gynecol Pathol 12: 333–343
Robboy SJ et al. (1995) Prognostic indices in malignant struma ovarii: a clinicopathologic analysis of 36 patients with 20-year follow up. Mod Pathol 8: 95A
Dardik RB et al. (1999) Malignant struma ovarii: two case reports and a review of the literature. Gynecol Oncol 73: 447–451
Nakamura N et al. (2006) Immunohistochemical separation of follicular variant of papillary thyroid carcinoma from follicular adenoma. Endocr Pathol 17: 213–223
Casey MB et al. (2003) Distinction between papillary thyroid hyperplasia and papillary thyroid carcinoma by immunohistochemical staining for cytokeratin 19, galectin-3, and HBME-1. Endocr Pathol 14: 55–60
Schmidt J et al. (2007) BRAF in papillary thyroid carcinoma of ovary (struma ovarii). Am J Surg Pathol 31: 1337–1343
Boutross-Tadross O et al. (2007) Follicular variant papillary thyroid carcinoma arising in struma ovarii. Endocr Pathol 18:182–186
Elisei R et al. (2005) RET/PTC3 rearrangement and thyroid differentiation gene analysis in a struma ovarii fortuitously revealed by elevated serum thyroglobulin concentration. Thyroid 15: 1355–1361
Brogioni S et al. (2007) A special case of bilateral ovarian metastases in a woman with papillary carcinoma of the thyroid. Exp Clin Endocrinol Diabetes 115: 397–400
DeSimone CP et al. (2003) Malignant struma ovarii: a case report and analysis of case reported in the literature with focus on survival and I131 therapy. Gynecol Oncol 89: 543–548
Makani S et al. (2004) Struma ovarii with a focus of papillary thyroid cancer: a case report and review of the literature. Gynecol Oncol 94: 835–839
Navarro MD et al. (2004) Malignant struma ovarii. Ann Clin Lab Sci 34: 107–112
Rose PG et al. (1998) Malignant struma ovarii: recurrence and response to treatment monitored by thyroglobulin levels. Gynecol Oncol 70: 425–427
Rotman-Pikielny P et al. (2000) Recombinant human thyrotropin for the diagnosis and treatment of a highly functional metastatic struma ovarii. J Clin Endocrinol Metab 85: 237–244
Ryder M et al. (2007) Follicular variant papillary thyroid carcinoma arising with an ovarian teratoma. Thyroid 17: 179–180
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Yassa, L., Sadow, P. & Marqusee, E. Malignant struma ovarii. Nat Rev Endocrinol 4, 469–472 (2008). https://doi.org/10.1038/ncpendmet0887
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DOI: https://doi.org/10.1038/ncpendmet0887
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