Review ArticleMetastatic Struma Ovarii Treated With Total Thyroidectomy and Radioiodine Ablation
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INTRODUCTION
Struma ovarii is a highly specialized ovarian teratoma composed predominantly or entirely of biologically active thyroid tissue. The thyroid tissue of the struma ovarii exhibits the same histologic, physiologic, and pharmacologic properties as cervical thyroid tissue (1). Approximately 5% of cases of struma ovarii are estimated to be malignant. Metastatic disease has been reported but is extremely rare. Because of the rarity of metastatic disease, treatment strategies have not been rigorously
CASE PRESENTATION
A 43-year-old woman with a history of a resected struma ovarii tumor presented with a pathologic left hip fracture after a 9-year disease-free interval. She underwent left hemiarthroplasty and bone biopsy. The pathology examination of the fracture site biopsy revealed metastatic adenocarcinoma, consistent with a primary thyroid lesion. The immunostain was positive for thyroglobulin. The slides from her prior salpingo-oophorectomy were obtained and demonstrated a struma ovarii tumor with
LITERATURE REVIEW
A MEDLINE literature search of the English language was performed, with use of the following terms: “malignant struma ovarii,” “struma ovarii,” and “malignant ovarian teratoma.” We identified 337 related articles, all of which were reviewed for relevance. The references were examined to identify additional relevant articles, including those that preceded the MEDLINE database. All cases of metastatic struma ovarii were collected.
In 1889, an ovarian tumor with follicular thyroid tissue was first
DISCUSSION
Struma ovarii tumor is a monodermal and highly specialized ovarian teratoma (36). Teratomas are neoplasms containing tissue that is foreign to the anatomic site in which they occur and are composed of 1 or more of the 3 embryonic germ layers. Struma ovarii is a teratoma in which more than 50% of the mass is composed of thyroid tissue. Only 3% of ovarian teratomas contain sufficient thyroid tissue to classify them as struma ovarii (37). Most cases of struma ovarii are benign. Literature reports
CONCLUSION
Struma ovarii is a rare ovarian tumor containing biologically active thyroid tissue. Review of the English-language literature revealed 40 reported cases of metastatic struma ovarii since the first reported case in 1910. Struma ovarii should be treated with appropriate primary tumor clearance. The National Comprehensive Cancer Network (38) guidelines on ovarian tumors recommend that patients with ovarian germ cell tumors undergo surgical resection and comprehensive staging. Unilateral
DISCLOSURE
The authors have no conflicts of interest to disclose.
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2023, International Journal of Surgery Case ReportsPoorly differentiated thyroid carcinoma arising in struma ovarii- a report of two extremely rare cases
2020, Human Pathology: Case ReportsCitation Excerpt :As in the thyroid gland, papillary thyroid carcinoma (>70%) and follicular carcinoma (approximately 30%) comprise the most common histological types in struma ovarii. Poorly differentiated thyroid carcinoma (PDTC) in struma ovarii is extremely rare.[3–8] We present two cases of PDTC arising in struma ovarii which posed diagnostic difficulties and morphologically mimicked high grade primary ovarian epithelial cancer.
Sincronous malignant struma ovarii and papillary thyroid carcinoma
2016, Endocrinologia y Nutricion