Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report

Abstract

Struma ovarii (SO) is a slow-growing ovarian neoplasm with thyroid tissue as its predominant component. It is an uncommon neoplasm, usually asymptomatic with an unknown risk of malignant transformation. Due to difficulties in assessing the rare biological nature and the discrepancies in the reported cases, a consensus on the appropriate treatment has not been definitively reached.A 50-year-old female was subjected to upper gut endoscopy which showed a 30-mm mass located in the gastric antrum, suggestive of mesenchimal tumor. Incidentally, a pelvic CT scan also documented a solid mass in the right adnexa, with morphological characteristics of ovarian neoplasm. The patient underwent gastrectomy, total hysterectomy, bilateral salpingo-oophorectomy with lymph node dissection, and omentectomy. Histology documented the presence of gastric cavernous angioma, and, in the right adnexa, foci of follicular thyroid-type carcinoma arising in SO with a well-differentiated neuroendocrine component.Here we report and discuss the clinical and morphological presentation of follicular thyroid-type carcinoma arising in SO. The neoplasm was discovered incidentally and had a favorable clinical outcome at 1-year follow-up.

An Unusual Case of Malignant Struma Ovarii Causing Thyrotoxicosis

“…We were able to find another report in the literature documenting foci of follicular thyroid-type carcinoma arising in SO with a well-differentiated neuroendocrine component [12]. The clinical and prognostic significance of these findings remains unknown.…”

“…Malignant SO consists of papillary thyroid carcinoma (PTC) cells, follicular variant of PTC or follicular thyroid carcinoma cells [12]. The most common type is PTC, followed by follicular thyroid carcinoma and the recent form of highly differentiated follicular carcinoma (HDFCO), which is characterized by extraovarian dissemination of thyroid elements [13].…”

Papillary Thyroid Cancer in a Struma Ovarii in a 17-Year-Old Nulliparous Patient: A Case Report

“…Unilateral salpingo-oophorectomy or cystectomy is recommended for women who wish to retain fertility [11,15]. For metastatic struma ovarii, the consensus is aggressive treatment including total thyroidectomy and adjuvant treatment with radioactive iodine (I-131); however, the role of thyroidectomy and adjuvant I-131 treatment in non-metastatic struma ovarii remains controversial [9,[15][16][17][18]. Here, we present the case of a 17-year-old girl with a follicular variant of papillary thyroid cancer arising in struma ovarii who was diagnosed after surgery to remove the left adnexa due to a large tumor in the left ovary.…”

An unusual presentation of a papillary thyroid carcinoma in the struma ovarii in a 10 year-old girl: A case report

“…As struma ovarii is diagnosed usually in women at older ages or menopauses, the recommended treatment is hysterectomy and bilateral salpingo-oophorectomy; but unilateral oophorectomy is the choice to preserve fertility in younger patients if there is no extra-ovarian disease. Thyroidectomy is usually recommended to confirm the normal thyroid gland by excluding a primary thyroid carcinoma and potentiate radioablation iodine therapy [ 10 ]. Prophylactic thyroidectomy would allow for thyroglobulin monitoring of possible metastases, remained mass or recurrence [ 10 ].…”

“…Thyroidectomy is usually recommended to confirm the normal thyroid gland by excluding a primary thyroid carcinoma and potentiate radioablation iodine therapy [ 10 ]. Prophylactic thyroidectomy would allow for thyroglobulin monitoring of possible metastases, remained mass or recurrence [ 10 ]. However, there are no guidelines in performing prophylactic total thyroidectomy after the diagnosis of thyroid type carcinoma in struma ovarii.…”