Struma Ovarii with Papillary Thyroid Carcinoma

Alvarez, Damaris; Lee, Victor; Bhatt, Shweta; Dogra, Vikram S.

doi:10.4103/2156-7514.84322

Cited by 14 publications

(9 citation statements)

References 9 publications

(16 reference statements)

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“…Being this tumor fairly uncommon, there is a lack of diagnostic and treatment guidelines ( 4 , 6 - 8 ). After initial surgery, some authors suggest that the management of malignant struma ovarii may be similar to that of other germ cell tumors ( 1 ); other authors suggest, as in differentiated cancer of thyroid gland management, to perform a thyroidectomy followed by radiotherapy with 131 isotope of Iodine (RAI) ( 9 ) and levothyroxine suppressive therapy ( 3 , 4 , 7 , 8 ), although restricted to patients with recurrence or residual disease ( 2 , 4 , 5 ). No consensus has been reached in performing prophylactic total thyroidectomy and the treatment strategy for nonmetastatic malignant disease remains controversial.…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Thyroid Carcinoma Confined To Ovary And Concurrently Occult in The Thyroid: Is Conservative Treatment Always Advised?

Brusca¹,

Duca²,

Salvatori

et al. 2014

Int J Endocrinol Metab

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Introduction:Struma ovarii is an ovarian teratoma, represented in more than 50% by thyroid tissue. Five percent of struma ovarii cases have been proven to be malignant and, as in the thyroid gland, papillary thyroid carcinoma is the most common histotype arising in struma ovarii. Because of the unusual occurrence of this tumor, its management and follow-up after pelvic surgery is still controversial. Usually, total thyroidectomy followed by radioiodine treatment is the choice treatment in metastatic malignant struma ovarii, while these procedures are still controversial in non-metastatic thyroid cancer arising in struma ovarii.Case Presentation:We report a female with follicular variant of papillary thyroid carcinoma arising in struma ovarii. After pelvic surgery, thyroid morphofunctional examinations were performed and a single nodular lesion in the left lobe was discovered. The patient underwent total thyroidectomy and histological examination showed a papillary carcinoma. Radioiodine-ablation of residual thyroid tissue was performed and levothyroxine mildly-suppressive treatment was started.Conclusions:A more aggressive treatment should not be denied for malignant struma ovarii without any evidence, even when apparently confined into the ovary. However, in selected cases, aggressive treatment may be advisable to decrease the risk of recurrence and to allow an accurate follow-up.

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Section: Introductionmentioning

confidence: 99%

A Case Report of Thyroid Carcinoma Confined To Ovary And Concurrently Occult in The Thyroid: Is Conservative Treatment Always Advised?

Brusca¹,

Duca²,

Salvatori

et al. 2014

Int J Endocrinol Metab

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“…Other procedures like total abdominal hysterectomy and bilateral oophorectomy should be considered as well. There are different recommendations for postoperative patient management, including thyroidectomy and iodine therapy for all the cases versus recurrence, metastasis, or residual disease after operation [9].…”

Section: Discussionmentioning

confidence: 99%

Papillary Thyroid Carcinoma in Struma Ovarii

Devi

Aghighi

Mikhail

2020

Cureus

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Struma ovarii is a variant of a germ cell tumor composed predominantly of thyroid tissue. It is most often unilateral. The incidence of malignancy arising in patients with struma ovarii is rare. Here, we present a case of struma ovarii in a female presented with abdominal distension. The patient was treated with a total hysterectomy and bilateral salpingo-oophorectomy, which revealed an enlarged cystically dilated ovary. Histopathologic examination showed mature thyroid follicles with abundant colloid consistent with struma ovarii and focal area with nuclear features of papillary thyroid carcinoma. No other teratomatous elements were identified. Thyroid hormone levels were within their respective reference ranges. A diagnosis of struma ovarii should be considered in the differential diagnosis of pelvic masses in peri-and postmenopausal patients.

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“…Teratomas are relatively common tumors of the ovaries, recognized in about 15–20% of cases of ovarian neoplasms [1, 2]. In about 15% of cases teratomas contain thyroid tissue [3, 4] which may (rarely) cause symptoms of hyperthyroidism [5, 6]. After hysterectomy with appendages the patient successfully obtained TSH stimulation and a significant decrease of thyroglobulin was observed, which indicates the presence of metabolic activity of thyroid tissue in the structure of the teratoma.…”

Section: Discussionmentioning

confidence: 99%

Lack of TSH stimulation in patients with differentiated thyroid cancer – possible causes

Gut¹,

Matysiak-Grześ²,

Fischbach³

et al. 2012

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Differentiated thyroid cancer is one of the most common endocrine cancers. Typical standard treatment includes total thyroidectomy with partial lymphadenectomy, then depending on the indications, treatment with iodine isotope 131-I. A prerequisite to conduct the therapy is to obtain endogenic thyroid-stimulating hormone (TSH) stimulation (TSH > 30 µU/ml). We describe two patients with differentiated thyroid carcinoma in whom no rise in serum TSH was observed after withdrawal of thyroxine. In one patient TSH deficiency was due to partial hypopituitarism secondary to a tumor of the pituitary gland. In the second patient the TSH level was suppressed by metabolically active thyroid tissue within bilateral ovarian teratomas. The problems with TSH growth after withdrawal of thyroxine requires additional studies to identify the cause. Above two possible reasons for the lack of TSH stimulation after withdrawal of thyroxine were presented. In the case of non-TSH stimulation due to hypopituitarism both control tests and isotope treatment should be carried out using stimulation by recombinant human TSH (rhTSH).

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Struma Ovarii with Papillary Thyroid Carcinoma

Cited by 14 publications

References 9 publications

A Case Report of Thyroid Carcinoma Confined To Ovary And Concurrently Occult in The Thyroid: Is Conservative Treatment Always Advised?

A Case Report of Thyroid Carcinoma Confined To Ovary And Concurrently Occult in The Thyroid: Is Conservative Treatment Always Advised?

Papillary Thyroid Carcinoma in Struma Ovarii

Lack of TSH stimulation in patients with differentiated thyroid cancer – possible causes

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