Thyroid type papillary carcinoma arising in a mature teratoma

Abstract

Struma ovary is a monodermal ovarian teratoma which contains mature thyroid tissue. We present an unusual case of papillary carcinoma arising in struma ovarii. A 52 year old post menopausal lady presented with a large right adnexal mass preoperatively diagnosed as a dermoid cyst. She underwent staging laparotomy and the histopatholgy report showed follicular variant of papillary carcinoma thyroid arising in a mature teratoma. She subsequently underwent total thyroidectomy to enable follow up with serum thyroglobulin and iodine scan. On follow up there is no evidence of disease recurrence.

The largest reported papillary thyroid carcinoma arising in struma ovarii and metastasis to opposite ovary: case report and review of literature

“…As for recurrence, our primary tumour was in the left ovary with PTC metastasis to the right ovary, but we are unable to report on recurrence as our patient left Qatar (lost to follow up). Treatments for the primary ovarian tumor include: TAH + BSO (considered ideal), with no recurrence over 6 months - 4 years follow up [ 22 , 24 ]; hysterectomy and unilateral oophorectomy/ unilateral salpingo-oopherectomy with no recurrence over 1–7 years [ 22 , 25 – 27 ]; bilateral salpingo-oophrerectomy with no recurrence over 2–5 years [ 28 , 29 ]; and unilateral oophorectomy/ unilateral salpingo-oophorectomy with no recurrence over 1–25 years [ 22 , 30 – 35 ]. Our patient received TAH + BSO that has good reported outcomes [ 22 , 24 , 29 ].…”

Coexistence of papillary thyroid cancer and Hashimoto's thyroiditis developing within an ovarian mature cystic teratoma

“…The incidence of malignant transformation in all ovarian tumors is 1%–3%. [567] The most common malignant tumor in mature cystic teratomas is squamous cell carcinoma, whereas papillary thyroid carcinoma arising from mature cystic teratoma is very rare. [8]…”

Malignant Transformation in Mature Cystic Teratomas of the Ovary: Case Reports and Review of the Literature

“…Malignant transformation occurs in 1.5-2% of the cases and usually consists of squamous cell carcinoma (4)(5)(6)(7)(8). Other less frequent malignancies include mucinous carcinoma (8)(9)(10), adenocarcinoma arising from the respiratory ciliated epithelium (11), melanoma (9), carcinoid (8), thyroid carcinoma (8,10,(12)(13)(14)(15), oligodendroglioma (10) and sarcoma (10).…”

“…The diameter of a squamous cell carcinoma arising in an ovarian MCT ranges from 9.7-15.6 cm (1, 4-8, 16, 17) and median age of patients is approximately 55 years (1,16), whereas the size of thyroid carcinoma in an MCT ranges from 5 to 20 cm and the median age of patients is about 42-45 years (12,15). The preoperative detection of malignant transformation is very difficult and the diagnostic accuracy of ultrasound, magnetic resonance imaging and computed tomography (CT) is uncertain (18)(19)(20)(21)(22)(23).…”

“…The preoperative detection of malignant transformation is very difficult and the diagnostic accuracy of ultrasound, magnetic resonance imaging and computed tomography (CT) is uncertain (18)(19)(20)(21)(22)(23). Malignancy is usually diagnosed post-operatively based on histopathologic findings (6,8,13,15,24).…”