Introduction: Struma ovarii is an ovarian teratoma, represented in more than 50% by thyroid tissue. Five percent of struma ovarii cases have been proven to be malignant and, as in the thyroid gland, papillary thyroid carcinoma is the most common histotype arising in struma ovarii. Because of the unusual occurrence of this tumor, its management and follow-up after pelvic surgery is still controversial. Usually, total thyroidectomy followed by radioiodine treatment is the choice treatment in metastatic malignant struma ovarii, while these procedures are still controversial in non-metastatic thyroid cancer arising in struma ovarii.
Case Presentation: We report a female with follicular variant of papillary thyroid carcinoma arising in struma ovarii. After pelvic surgery, thyroid morphofunctional examinations were performed and a single nodular lesion in the left lobe was discovered. The patient underwent total thyroidectomy and histological examination showed a papillary carcinoma. Radioiodine-ablation of residual thyroid tissue was performed and levothyroxine mildly-suppressive treatment was started.
Conclusions: A more aggressive treatment should not be denied for malignant struma ovarii without any evidence, even when apparently confined into the ovary. However, in selected cases, aggressive treatment may be advisable to decrease the risk of recurrence and to allow an accurate follow-up.
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| http://dx.doi.org/10.5812/ijem.18220 | DOI Listing |
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Article Synopsis
- - Malignant struma ovarii (MSO) is a rare type of ovarian goiter that meets criteria for malignant thyroid tumors and can show invasive spread, with serum thyroglobulin (Tg) levels helping to differentiate it from other ovarian cancers.
- - A case study is presented involving a 54-year-old woman with abdominal pain, diagnosed post-surgery with highly differentiated follicular thyroid carcinoma originating from both ovaries, which had spread to other areas.
- - After undergoing total thyroidectomy and iodine-131 treatment, her follow-up after one year showed no significant abnormalities, highlighting the need for further discussion on clinical management and monitoring of Tg levels in MSO cases.
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