RESUMO
Ovarian carcinoid is a rare tumor accounting for approximately 0.1% of all ovarian malignancies. We describe a case of peptide-YY-producing strumal carcinoid of the ovary associated with severe constipation. A 48-year-old woman was found to have a pelvic mass on ultrasonography when she visited her primary doctor for a health check-up. She was thus referred to our department. Magnetic resonance imaging revealed a solid right ovarian tumor 60 × 50 mm in size. The patient underwent a right adnexectomy and was histopathologically diagnosed as having strumal carcinoid of the ovary. On immunohistochemical examination, the tumor cells were positive for peptide YY. The patient's constipation resolved rapidly after surgery. Based on her clinical course, her constipation was considered to have been caused by the strumal carcinoid of the ovary. The clinical course of this case supports the previously recognized correlation between peptide-YY-producing ovarian carcinoid and constipation.
Assuntos
Tumor Carcinoide/fisiopatologia , Constipação Intestinal/etiologia , Proteínas de Neoplasias/metabolismo , Neoplasias Ovarianas/fisiopatologia , Peptídeo YY/metabolismo , Estruma Ovariano/fisiopatologia , Tumor Carcinoide/metabolismo , Tumor Carcinoide/cirurgia , Constipação Intestinal/fisiopatologia , Constipação Intestinal/prevenção & controle , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/cirurgia , Ovário/metabolismo , Ovário/cirurgia , Índice de Gravidade de Doença , Estruma Ovariano/metabolismo , Estruma Ovariano/cirurgiaRESUMO
Our objective was to evaluate the preoperative clinical, laboratory, and sonographic characteristics of struma ovarii in comparison to ovarian dermoid cysts. A retrospective review of gynecologic patients operated on for mature cystic teratoma over a 10 year period identified 12 cases of struma ovarii. These cases, combined with 4 additional cases from an earlier report, were the subject of this study. Results were compared to 32 cases of ovarian dermoid cysts. Ovarian struma ovarii occurred in 12 (4.8%) of 251 cases of ovarian dermoid cysts. Most patients were premenopausal, and the mean lesion diameter was 57.3 mm (range, 30-95 mm). Struma ovarii occurred more frequently (68.8%) in the right adnexa and was seen with a normal CA-125 level. Blood flow, assessed by Doppler ultrasonography, was located in the center of the lesion in all cases of struma ovarii. Rare cases were seen with elevated tumor markers and low resistance blood flow. With regard to dermoid cysts, blood flow had a higher resistive index. In addition, no blood flow could be detected from the center of the echoic lesion in dermoid cysts (P < 0.0001). In summary, it is difficult to distinguish between struma ovarii and dermoid cysts on the basis of their sonographic appearance. Nevertheless, Doppler flow may aid in the preoperative diagnosis of struma ovarii. Blood flow signals, detected from the center of the echoic lesion, and low resistance to flow may be more common in struma ovarii.
Assuntos
Neoplasias Ovarianas/diagnóstico por imagem , Estruma Ovariano/diagnóstico por imagem , Ultrassonografia Doppler , Adulto , Velocidade do Fluxo Sanguíneo , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/fisiopatologia , Neoplasias Ovarianas/fisiopatologia , Estudos Retrospectivos , Estruma Ovariano/fisiopatologiaRESUMO
BACKGROUND: Malignant struma ovarii is a rare tumor, consisting of a struma ovarii with malignant change. Because of the rarity of the tumor, only a few reports with detailed data of thyroid function of the patient have been published. CASE: Medical and surgical treatments were performed in a case of malignant struma ovarii with Graves' disease and data from thyroid function tests were analyzed. After removal of the tumor, rapid improvement of thyroid function was observed and thyroglobulin level decreased. CONCLUSION: This case demonstrates the possible, if not dominant, contribution from the malignant struma ovarii to the hyperthyroidism of the patient.
Assuntos
Doença de Graves/complicações , Neoplasias Ovarianas/complicações , Estruma Ovariano/complicações , Feminino , Doença de Graves/fisiopatologia , Humanos , Hipertireoidismo/etiologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/fisiopatologia , Neoplasias Ovarianas/cirurgia , Estruma Ovariano/fisiopatologia , Estruma Ovariano/cirurgia , Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/metabolismoRESUMO
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Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Hemangioma/complicações , Hemangioma/diagnóstico , Biomarcadores Tumorais/análise , Laparotomia/métodos , Ovariectomia/métodos , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Estruma Ovariano/complicações , Teratoma/complicações , Ovariectomia/tendências , Ovariectomia , Neoplasias Vasculares/complicações , Neoplasias Vasculares/diagnóstico , Estruma Ovariano/diagnóstico , Estruma Ovariano/fisiopatologia , Estruma Ovariano/cirurgiaAssuntos
Humanos , Adulto , Pessoa de Meia-Idade , Feminino , Colonoscopia , Endometriose/complicações , Endometriose/fisiopatologia , Endometriose/terapia , Histerectomia , Enteropatias/etiologia , Enteropatias/fisiopatologia , Enteropatias/terapia , Laparotomia , Salpingostomia , Estruma Ovariano/diagnóstico , Estruma Ovariano/fisiopatologia , Tomografia Computadorizada de EmissãoRESUMO
Se presenta el caso clínico de una paciente de 47 años de edad a la que dos años antes se les practicó histerectomía con salpingo-oforectomía bilateral por tumor ovárico reportado como un tumor de la granulosa. Acude nuevamente con cuadro de paraplejía secundaria a comprensión medular por fractura patológica de vértebra dorsal (T7-8). Se le practica laminectomía de la lesión vertebral osteolítica, la que se reporta como correspondiente a un carcinoma folicular de tiroides metastásico. Posteriormente es sometida a una tiroidectomía total, la pieza de esta ocasión se reportó como "glándula tiroidea normal". En busca de la lesión primaria se reexamina la pieza y laminillas de histerectomía, diagnosticándose un carcinoma folicular y struma ovarii. Es tratada con Iodo 131, recupera la motilidad y cinco años después se encuentra en perfectas condiciones, haciendo vida normal. Se hacen comentarios sobre dicha entidad