Radiotherapy with iodine-131 in recurrent malignant struma ovarii

Abstract

Malignant struma ovarii is a very rare disease and, therefore, there is neither common agreement on treatment regimens nor sufficient follow-up experience. We present a case of a 49-year-old woman with malignant struma ovarii of the follicular type, who received ablative radioiodine treatment after thyroidectomy and surgical removal of the primary tumour. During follow-up examinations an increasing thyroglobulin level was found, caused by a tumour relapse with suspected urinary bladder infiltration on CT and proven uptake of radioiodine on whole-body scanning with iodine-131. After administration of 6GBq 131I, complete tumour regression was achieved with no evidence of a new relapse during a 30-month follow-up period. Correspondingly, repeated thyroglobulin measurements were all negative. This case demonstrates the benefit of combined surgical and radioiodine treatment of malignant struma ovarii for both monitoring and therapy of relapse or metastases; thus, the same therapeutic regimen as is employed in primary differentiated thyroid carcinoma may be recommended.

Malignant Struma Ovarii – A Case Report and Review of the Literature

“…In contrast, some authors believe that patients with malignant struma ovarii should be treated as if they have a thyroid cancer. When there is residual malignant disease after surgery, they recommend a total thyroidectomy and radioablation with 131 I [10,[21][22][23] . Some authors recommend adjuvant therapy including thyroidectomy ablation with 131 I for patients with advanced disease and those with metastases or recurrent disease [14] .…”

Predominant Brenner Tumor Combined with Struma Ovarii Containing a Papillary Microcarcinoma Associated with Benign Peritoneal Strumosis: Report of a Case and Histologic Features

“…The possible advantages of external radiotherapy, chemotherapy, and thyroid suppression or thyroidectomy, especially in treating recurrent disease, remain debatable [15,16]. Some investigators have recently proposed ablative radioiodine treatment and thyroidectomy in patients with malignant struma ovarii as a first approach [15] or for relapsing disease [16,18].…”

Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment

“…A more-aggressive approach is recommended for postmenopausal women, whereas for younger patients unilateral oophorectomy may be attempted if there is unilateral teratoma without any evidence of capsular invasion or metastatic spread. Under the assumption of detecting distant thyroid cancer cells, a radioiodine body scan (which was unsuspicious in our patient) is an established diagnostic option for further treatment decisions and follow-up (25)(26)(27).…”