Precise preoperative diagnosis of struma ovarii with pseudo-Meigs’ syndrome mimicking ovarian cancer with the combination of 131I scintigraphy and 18F–FDG PET: case report and review of the literature

Fujiwara, Sayaka; Tsuyoshi, Hideaki; Nishimura, Toshiya; Takahashi, Nobuhiro; Yoshida, Yoshio

doi:10.1186/s13048-018-0383-2

Cited by 26 publications

(40 citation statements)

References 50 publications

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“…Ovarian teratomas are the most common germ cell tumors and represent ∼20% of all ovarian tumors (1); these tumors contain tissue from the three germ layers, typically including hair, skin, bone, and thyroid tissue. Struma ovarii is a rare form of ovarian teratomas, are composed of more than 50% thyroid tissue (2), and account for about 2% to 5% of ovarian teratomas and 0.5 to 1% of all ovarian tumors (3)(4)(5). Between 5 and 10% of struma ovarii cases are defined as MSO by the World Health Organization (WHO) and are histologically identified to differentiate from thyroid carcinomas (6).…”

Section: Introductionmentioning

confidence: 99%

FIGO Stage IV and Age Over 55 Years as Prognostic Predicators in Patients With Metastatic Malignant Struma Ovarii

Yang

et al. 2020

Front. Oncol.

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Introduction: Metastatic malignant struma ovarii (MSO) is an extremely rare disease that lacks treatment consensus and accurate prognosis. The objective of this study was to present the clinical, pathological, and treatment characteristics of metastatic MSO, while also investigate the overall survival (OS) rate and factors affecting prognosis in this population. Materials and Methods: A total of 79 cases of metastatic MSO were reviewed, including four cases of metastatic MSO from our hospital and 75 cases selected from the literature. Logistic regression was used to identify potential factors affecting disease free survival (DFS). The Kaplan-Meier method and log-rank test were used to determine OS; further Cox regression was used to evaluate factors affecting OS. Results: The mean age of all the patients at diagnosis was 43.8 years. The most common metastatic sites were peritoneum, bone, liver, omentum and lung in descending order. Only two patients (2.6%) coexisted with local primary thyroid cancer. Follicular carcinoma (41.8%) as the most prevalent subtype, followed by papillary carcinoma, follicular variant of papillary carcinoma, and mixed follicular-papillary carcinoma. 36.7% of the patients received conservative surgery, 43.0% of them underwent aggressive surgery, and 15.2% of them did not receive any surgery. 74.7% of patients who received adjuvant therapy underwent radioiodine therapy (RAI). Logistics regression revealed that FIGO stage IV was the only prognostic factor in predicting DFS (P = 0.002; Odds Ratio [OR] 5.333; 95% confidence interval [CI]: 1.839-15.471). Only seven deaths occurred. The OS rates at 5, 10, 15 years were 89.3, 82.4, 65.9%, respectively. Multivariate analysis showed age over 55 years (P = 0.006; OR 9.362; 95%CI: 1.895-46.246) was the only risk factor for OS. Conclusion: Patients with metastatic MSO have an excellent disease-specific OS rate, FIGO stage IV and age over 55 years were two factors affecting disease prognosis. Conservative surgery with residual ablation by RAI after total thyroidectomy should be preferred since the benefits of aggressive surgery are uncertain.

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Section: Introductionmentioning

confidence: 99%

FIGO Stage IV and Age Over 55 Years as Prognostic Predicators in Patients With Metastatic Malignant Struma Ovarii

Yang

et al. 2020

Front. Oncol.

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“…[ 18 ] A definitive diagnosis of Meigs syndrome or PMS can only be made in retrospect following the resolution of fluid accumulations after removing the ovarian tumor. [ 19 ] It is of clinical significance to use these syndromes as the differential diagnosis of pleural effusion, especially in young women who desire fertility or pregnant.…”

Section: Discussionmentioning

confidence: 99%

Ovarian dysgerminoma with pseudo-Meigs syndrome

Chen

Jin

et al. 2021

Medicine

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Rationale: Dysgerminoma is a rare malignant tumor of the ovary, more frequently occurring in young women. The main signs of pseudo-Meigs syndrome (PMS) are ascites and hydrothorax accompanying benign or malignant ovarian tumors (no fibroma or fibroma-like tumor). Patient concerns: A 19-year-old woman with fever and chest tightness for 2 days. Diagnoses: Pectoral-abdominal computed tomography (CT) scan and contrast-enhanced magnetic resonance imaging revealed a large amount of right pleural effusion, a small amount of ascites, and a huge abdominopelvic mass measuring about 29.2cm × 11.8cm × 8.4 cm in the left ovary. The result of hydrothorax examination was consistent with the diagnosis of exudative pleural effusion. In addition, Rivalta-test showed a positive result and lactate dehydrogenase was elevated. The histopathological diagnosis was a giant germ cell tumor, which was consistent with dysgerminoma in terms of both morphology and immunophenotype. Based on these findings, a diagnosis of malignant ovarian neoplasm with PMS was made. Interventions: Surgical resection of the tumor was performed. Outcomes: The patient recovered well after operation, and the pleural effusion and abdominal ascites vanished. No recurrence was observed during the 1-year follow-up period. Lessons: Ovarian dysgerminoma with PMS is a rare malignant tumor of the ovary, which often occurs in young women. It should be considered in differential diagnosis of patients with a pelvic mass, ascites and pleural effusion. Early diagnosis and surgical treatment are beneficial to prolonged survival.

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“…The large tumor size, abundant adhesions, and ovarian serosal defects are high-risk features of struma ovarii that may be associated with aggressive behaviors (1,8). Mildly elevated CA-125 levels are found in up to 30% of these tumors, although in the presence of ascites, this level may be higher (1,9). Case reports have shown that higher levels of CA-125 were associated with a higher volume of ascites; however, the size of the tumor was not linearly correlated with the CA-125 level (10,11).…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound is non-specific and generally contains solid components or thick septa in the cystic component similar to an ovarian malignancy (1,7). On the other hand, successful preoperative diagnosis of a struma ovarii, associated with pseudo-Meigs' syndrome, has been reported using a combination of 18F-FDG PET/CT and 131I scintigraphy (9). These tumors are classically unilateral, and less than 1% of them are reported to be bilateral.…”

Section: Discussionmentioning

confidence: 99%

A Struma Ovarii Associated with Pseudo-Meigs’ Syndrome is Misdiagnosed as Advanced Ovarian Cancer: A Case Report

et al. 2021

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Introduction: A struma ovarii is a benign monodermal teratoma, composed of mature thyroid tissue. The presentation of this disease with pseudo-Meigs’ syndrome [characterized by ascites, pleural effusions, and elevated cancer antigen-125 (CA-125) levels] may result in an advanced ovarian cancer misdiagnosis. Case Presentation: The patient was a 54-year-old woman with dyspnea, abdominal distention, and pseudo-Meigs’ syndrome. She had a final diagnosis of struma ovarii, misdiagnosed as advanced ovarian cancer. She is currently asymptomatic (after surgery) and has a normal CA-125 level. Conclusions: The preoperative diagnosis of struma ovarii is difficult, and if it presents with pseudo-Meigs’ syndrome, it may be initially misdiagnosed as advanced ovarian cancer. Using the frozen-section procedure, unnecessary extensive surgeries can be prevented.

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Precise preoperative diagnosis of struma ovarii with pseudo-Meigs’ syndrome mimicking ovarian cancer with the combination of 131I scintigraphy and 18F–FDG PET: case report and review of the literature

Cited by 26 publications

References 50 publications

FIGO Stage IV and Age Over 55 Years as Prognostic Predicators in Patients With Metastatic Malignant Struma Ovarii

FIGO Stage IV and Age Over 55 Years as Prognostic Predicators in Patients With Metastatic Malignant Struma Ovarii

Ovarian dysgerminoma with pseudo-Meigs syndrome

A Struma Ovarii Associated with Pseudo-Meigs’ Syndrome is Misdiagnosed as Advanced Ovarian Cancer: A Case Report

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