Struma Ovarii with Elevated Ca-125 Levels and Ascites Mimicking Advanced Ca Ovary

Sinha, Nirmal K.

doi:10.7860/jcdr/2014/8005.4138

Cited by 8 publications

(10 citation statements)

References 8 publications

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“…Our patient presented with ascites and markedly elevated CA 125 and Tg and mild elevation of CA-19 9 which shifted the clinical diagnosis initially towards ovarian cancer. Ascites is associated with malignant SO in 17-33% of cases, but the ascitic fluid rarely contains malignant cells and CA-125 is rarely increased (5,9). CA 19-9 elevation was not mentioned in previous case reports of malignant SO but was mentioned to be elevated in a case of stromal carcinoid (10).…”

Section: Discussionmentioning

confidence: 91%

Papillary follicular variant thyroid cancer in a malignant struma ovarii: a report of a rare case

Elshafie¹,

Hussein

Kalbani³

et al. 2022

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary A 33-year-old female presented in 2013 with left flank pain. Ultrasound and MRI pelvis showed a complex mass 9 × 7 cm arising from the left ovary suggestive of ovarian torsion. She underwent a laparoscopic cystectomy, but the patient was lost to follow-up. Three years later, she presented with abdominal distension. Ultrasound and CT scan revealed a solid left ovarian mass with ascites and multiple peritoneal metastasis. Investigations showed elevated CA 125, CA 19-9. Ovarian malignancy was suspected. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy on November 2016. The histopathology confirmed a well-differentiated thyroid cancer of ovarian origin with features of a papillary follicular variant without evidence of ovarian cancer and the thyroglobulin (Tg) level was elevated, more than 400 consistent with the diagnosis of malignant struma ovarii. The follow-up post-surgery showed normalization of CA 125, CA 19-9 and Tg. The patient underwent total thyroidectomy on January 2017. The histology was benign excluding thyroid cancer metastases to the ovary. She was started on thyroxine suppression, following which she received two ablation doses 131iodine (131I) each 5.3 GBq. The Tg remains slightly elevated at less than 10. 131I WBS showed no residual neck uptake and no distant avid metastasis. She was planned for molecular analysis which may indicate disease severity. We describe a case of malignant struma ovarii with widespread metastatic dissemination and a good response to surgery and 131I treatment without recurrence after 5 years of follow-up. The Tg remains slightly elevated indicating minimal stable residual disease. Learning points Malignant struma ovarii is a rare disease; diagnosis is difficult and management is not well defined. Presentation may mimic advanced carcinoma of the ovary. Predominant sites of metastasis are adjacent pelvic structures. Thyroidectomy and 131iodine therapy should be considered. The management should be similar to that of metastatic thyroid cancer.

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Section: Discussionmentioning

confidence: 91%

Papillary follicular variant thyroid cancer in a malignant struma ovarii: a report of a rare case

Elshafie¹,

Hussein

Kalbani³

et al. 2022

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…2021; 14(9):e110036. pelvic imaging (1,5,6). Malignant ovarian stromal tumors, which occur in 0.3 to 5% of all these tumors, show the histological features of thyroid follicular adenomas (proliferative stromal changes) or papillary carcinomas (1,7).…”

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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“…Most struma ovarii are benign with only 5-10% being malignant. 11 The preoperative diagnosis, in the absence of clinical evidence of hyperthyroidism is difficult. Surgery is the treatment of choice for benign tumors.…”

Section: Discussionmentioning

confidence: 99%

Benign Tumor Mimicking Malignancy

Manikkam¹

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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In routine gynecological practice, benign tumor mimicking malignancies are rarely thought of as differential diagnosis. It is always mandatory to consider malignancy as the first diagnosis so that the clinician`s approach will be with a bird`s eye view. The diagnosis of malignancy will have a pronounced bearing mentally for the affected women. We confronted one such interesting case in our institution. The patient had undergone prior surgeries and recovered from serious postoperative complications. In addition, she poses a higher risk for anesthesia. Above all, to counsel the patient and the family about the impact of the current problem is a Herculean task. The scenario takes a different upturn with the histopathology report. The effort by the multidisciplinary team proves fruitful.

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Struma Ovarii with Elevated Ca-125 Levels and Ascites Mimicking Advanced Ca Ovary

Cited by 8 publications

References 8 publications

Papillary follicular variant thyroid cancer in a malignant struma ovarii: a report of a rare case

Papillary follicular variant thyroid cancer in a malignant struma ovarii: a report of a rare case

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

Benign Tumor Mimicking Malignancy

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