Usefulness of 131I-SPECT/CT and 18F-FDG PET/CT in Evaluating Successful 131I and Retinoic Acid Combined Therapy in a Patient with Metastatic Struma Ovarii

Abstract

Metastatic struma ovarii is an extremely rare disease, and the treatment of choice has not been established. Here, we introduce the case of a 36-year-old female pregnant patient with metastatic struma ovarii. Initial treatment was an exploratory laparotomy to remove multiple peritoneal masses. After delivery, a total thyroidectomy was done for the further 131 I-therapy.

Precise preoperative diagnosis of struma ovarii with pseudo-Meigs’ syndrome mimicking ovarian cancer with the combination of 131I scintigraphy and 18F–FDG PET: case report and review of the literature

“…The usefulness of thyroid scintigraphy for the preoperative diagnosis of malignant struma ovarii is still unclear, because most cases are histologically diagnosed after surgery. The usefulness of thyroid scintigraphy in follow-up or evaluation of radioablation with 131 I for malignant struma ovarii has been reported [ 45 – 48 ]. However, the sensitivity may be low for detection of residual or recurrent malignant tissue if the thyroid gland is not removed [ 49 ].…”

“…Benign struma ovarii does not show FDG uptake [ 34 , 37 ]. However, malignant struma ovarii shows FDG uptake, and this may be useful for evaluation of the biological characteristics and the detection of the metastatic or recurrent lesions [ 45 – 47 ]. There are no reports about the usefulness of FDG PET for ovarian metastasis from primary thyroid carcinoma.…”

Maximum Standardized Uptake Value of99mTc Hydroxymethylene Diphosphonate SPECT/CT for the Evaluation of Temporomandibular Joint Disorder

“…Integration of SPECT with x-ray computed tomography (CT), producing a hybrid scanner of SPECT/CT, was the next step, following the successful clinical application of positron emission tomography (PET)/CT (8,9). In fact, the usefulness of SPECT/CT is being demonstrated in many areas of gamma camera imaging (10)(11)(12)(13).…”

Accurately localizing the thyroid tissue in mature cystic teratoma of ovary by single-photon emission computerized tomography/computerized tomography

“…[ 1 ] Clinical features may resemble ovarian malignancy and rarely can be metastatic. [ 2 3 4 5 ] Typically presents as a multicystic mass with lobulated surface and thickened septic or cyst walls with some solid components. High attenuation areas and calcifications in the solid components are common findings on CT images.…”

“…[ 6 ] Scintigraphy with Tc-99m pertechnetate, I-123, and I-131 was used for diagnosing a hyperfunctioning struma ovarii on the basis of higher uptake of the radionuclide with planar images. [ 2 3 4 5 ] If the clinicians or nuclear medicine physician does not consider the extrathyroidal tissue as a result of hyperthyroidism patient's diagnosis cannot be made by the other nuclear medicine test such as I-131 uptake and thyroid scintigraphy. So, the extrathyroidal cause of hyperthyroidism can lead to the dilemma in nuclear medicine.…”