Malignant Struma Ovarii – A Case Report and Review of the Literature

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Women's Health, Bronx, NY 10461, USA.
Gynecologic and Obstetric Investigation (Impact Factor: 1.7). 02/2008; 65(2):104-7. DOI: 10.1159/000108654
Source: PubMed


Struma ovarii is a rare monodermal ovarian teratoma composed predominantly of mature thyroid tissue. Of these cases, 5-8% are clinically hyperthyroid and 5-10% of these tumors are malignant.
A 53-year-old female presented with a 19 x 5 x 5 cm pelvic mass that was treated with bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node sampling, omentectomy and appendectomy and staging for an ovarian tumor. There was no evidence of distant metastases or lymph node invasion. Re-evaluation of the patient after surgery revealed that she was clinically euthyroid and there was no thyroid malignancy. Histopathology revealed papillary thyroid carcinoma arising in struma ovarii (malignant struma ovarii).
Malignant struma ovarii is a very rare malignant ovarian teratoma. In young patients unilateral oophorectomy and complete surgical staging should be considered when the tumor is confined to the one ovary (stage Ia). Long-term follow-up for the detection of metastases or tumor recurrence by serial serum thyroglobulin and (131)I scan or positron emission tomography/computed tomography may be required in selected patients with this rare tumor.

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    • "This kind of treatment is radical :radical total hysterectomy, omentectomy, biopsies of pelvic and lombo-aortics nodes and a cytologic test of the peritoneal fluid(Hatami et al., 2008). For a young patient, with desire of conception, an unilateral salpingooophorectomy can be realized with a complete examination of the abdominal cavity and biopsies of the controlateral ovary(Hatami et al., 2008).This treatment can be only applied naturally to tumors which are confined to the ovary. During the surgery, a scintigraphic exam with 131-iodine is necessary to exclude metastasis and in case of lack of secondary lesions, no adjuvant treatment is indicated. "

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