Malignant struma ovarii: from a perspective of thyroid surgery / 中华内分泌外科杂志

Struma ovarii is a highly specialized form of monoderal ovarian teratoma, in which thyroid tissue has exceeded all other tissues or only thyroid tissue malignant struma ovarii is a very rare disease. Studies have confirmed that the pathogenesis is basically consistent with primary thyroid cancer. Preoperative diagnosis is difficult and the diagnosis should be based on postoperative paraffin pathology. It’s important to emphasize that the histologic malignance does not represent malignant ovarian behavior. Transabdominal hysterectomy+bilateral salpingo-oophorectomy has a better prognosis, and there are different opinions on the management of the mainstream thyroid. Most patients take active thyroid excision followed by chemotherapy and radiotherapy and 131I for postoperative follow-up in accordance with the principle of primary thyroid cancer.

Follicular Proliferative Lesion Arising in Struma Ovarii

Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibited solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as "proliferative stromal ovarii" or "follicular proliferative lesion arising in the stromal ovarii" would be appropriate.

Struma ovarii maligno / Malignant Struma ovarii

O "Struma ovarii" é um tumor ginecológico raro, sendo de malignização e metástases incomuns. Constituído predominantemente por tecido tireoideano, apresenta maior incidência aos 50 anos. Apresentamos o caso de uma paciente de 41 anos com história prévia de teratoma tratado, que desenvolve dor pélvica e tumoração abdominal. Operada, concluiu-se tratar de "Struma ovarii" maligno com metástases. Após a radioablação com I-131, encontra-se sob controle clínico. Apesar de sua raridade, o "Struma ovarii" possui bom prognóstico, devendo ser lembrado no diagnóstico diferencial dos tumores ovarianos.

Unilateral malignant struma ovarii in a case of bilateral ovarian teratoma with raised CA-125 level: A rare case with treatment dilemmas.

Struma ovarii are specialized form of mature ovarian teratoma comprised predominantly of thyroid tissue (>50%). Most of the struma ovarii are benign; rarely can they undergo malignant transformation. Elevated CA-125 levels with benign struma ovarii have been seen in only 5 cases in literature. The association of malignant struma ovarii and high CA-125 levels with pseudo-Meig syndrome has been reported in only 2 cases in English literature. We describe a case of a 46-year-old multigravida who presented with an abdominal mass and raised CA-125 levels. Radiological investigations revealed bilateral cystic adnexal masses with ossified elements on left side suggesting a teratoma. Intraoperative frozen section and final pathology revealed bilateral teratoma with follicular variant of papillary thyroid carcinoma arising in the left ovary. To the best of our knowledge, this is the first case of malignant struma ovarii in combination with bilateral teratoma. The dilemmas related to preoperative diagnoses with elevated CA-125 levels, mimicking an epithelial ovarian neoplasm; intraoperative frozen section consultation; management and follow-up issues in this rare malignancy are discussed.

A Case of Malignant Struma Ovarii / 대한산부인과학회잡지

Struma ovarii consists of thyroid tissue derived from germ cells in a mature teratoma and which all or a large part is composed of thyroid tissue. Malignant transformation and clinically evident metastatic disease are very rare. The rarity of malignant struma ovarii renders evaluation of treatment modality difficult. There is evidence that these tumors behave like their thyroid counter parts, and cytoreductive surgery followed by ablation with radioactive iodine has been advocated. We have experienced a case of malignant struma ovarii. In this report, we present clinical and pathological findings of a case of malignant struma ovarii of 51-year-old patient with a review of the concerned literatures.

A Case of Malignant Struma Ovarii / 대한산부인과학회잡지

Struma Ovarii is a teratoma with thyroid tissue as the predominant (>50%) constituent. It is rare, representing about 2% of all teratomas, and its malignant transformation, less than 5% of struma ovarii. Presenting symptoms are not specific, therefore pre-operative diagnosis of malignant struma ovarii is difficult and most diagnosis of malignant struma ovaii is determined by post-operative histologic findings. Because of the rarity of malignant struma ovarii, there is considerable confusion concerning diagnosis and management. A postmenopausal woman presented with pelvic mass and lower abdominal pain and explo-laparotomy was performed. Then, pathologic report was identified as malignant struma ovarii. We report a case of malignant struma ovarii with brief review of literature

A Case Report: Malignant struma ovarii / 대한산부인과학회잡지

About 15 to 20% of ovarian tumors are of germ cell origin, and about 95% of these are cystic teratoma. when the teratoma is composed either entirely or predominantly of thyroid tissue, it called struma ovarii. Struma ovarii represents about 2.7% of cystic teratoma. The incidence of malignant struma ovarii is probably much less than 5% of all struma ovarii. We have observed a case of malignant struma ovarii originated from the left ovary of a 46-year-old woman, and present this case with a brief review of concerned literatures.

Malignant Struma Ovarii: two cases report and literature review / 대한산부인과학회잡지

Struma ovarii consists of thyroid tissue which is derived from germ cells in a mature teratoma. Five percent of struma ovarii are malignant, and of these only five percent metastasize. The rarity of this disease has resulted in difficulty in agreeing on treatment regimens and in limited imaging and monitoring difficulties encountered in their management. We have experienced two cases of malignant struma ovarii with brief review of the literature.

Malignant Struma Ovarii: A case report

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.

Malignant Struma Ovarii: A case report

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.