Papillary thyroid cancer found in struma ovarii: A case report

2013 ◽  
Vol 21 (3-4) ◽  
pp. 141-142
Author(s):  
Ivan Majdevac ◽  
Dejan Lukic ◽  
Milan Ranisavljevic
Keyword(s):  
Thyroid Carcinoma ◽  
Endometrial Carcinoma ◽  
Germ Cells ◽  
Histopathological Examination ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Point Of View ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Malignant Struma Ovarii

Struma ovarii is composed of thyroid tissue originated from germ cells in a mature teratoma. Thyroid carcinoma found in struma ovarii is very rare. Primary thyroid carcinoma should be excluded. We present a 62-year-old female with papillary thyroid carcinoma in a mature teratoma as a incidentally found diagnosis. The patient underwent the surgery because of the endometrial carcinoma, while the histopathological examination found endometrial carcinoma as well as malignant struma ovarii. From the surgical point of view, it is very important to evaluate thyroid gland status in patients with malignant struma ovarii.

scholarly journals SUN-LB81 Coexisting Malignant Struma Ovarii and Cervical Follicular Variant Papillary Thyroid Carcinoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jubran Afzal Khan Rind ◽  
Zeb Ijaz Saeed
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Mature Teratoma ◽  
Clinical Endocrinology ◽  
Lymphatic Invasion ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Lower Quadrant ◽  
Malignant Struma Ovarii

Abstract A 44-year-old woman presented with left lower quadrant abdominal pain for 2 months. Further evaluation revealed a left adnexal mass and she underwent a TAH-BSO. A 12 cm mass arising from the left ovary was resected which on microscopy appeared to be papillary thyroid carcinoma follicular variant arising from a mature teratoma (struma ovarii). A thyroid ultrasound showed two subcentimeter right thyroid nodules without any concerning lymphadenopathy. A total thyroidectomy was then performed to allow her to receive adjuvant RAI. The cervical thyroid pathology showed a 0.6 cm follicular variant papillary thyroid carcinoma with negative margins without angioinvasion, lymphatic invasion or extrathyroidal extension. Thyroid hormone suppression with levothyroxine was started. Preoperatively, thyroglobulin was 1381 ng/ml (nl range 1.3-31.8 ng/ml). After TAH-BSO and thyroidectomy, thyroglobulin was undetectable and so was the anti-thyroglobulin antibody. With an undetectable thyroglobulin level, it was decided not to pursue adjuvant RAI and continue TSH suppression with levothyroxine. Simultaneous existence of malignant struma ovarii and cervical papillary thyroid cancer is rare and has a favorable prognosis compared to metastasis to the ovaries from primary cervical thyroid papillary carcinoma. Due to the rarity of this condition, management is not clear or well supported by evidence. Various approaches are suggested by different authors, including thyroidectomy after resection of malignant struma ovarii to facilitate adjuvant RAI, only performing surgical resection of the ovarian tumor in the absence of high risk features or performing thyroidectomy and RAI only in metastatic or recurrent disease. References:1.Aaron Leong, Philip J. R. Roche, Miltiadis Paliouras, Louise Rochon, Mark Trifiro, Michael Tamilia, Coexistence of Malignant Struma Ovarii and Cervical Papillary Thyroid Carcinoma, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 12, 1 December 2013, Pages 4599-46052.Synchronous malignant struma ovarii and papillary thyroid carcinoma Pablo Fernández Catalina,Antonia Rego Iraeta, Mónica Lorenzo Solar, Paula Sánchez Sobrino DOI: 10.1016/j.endoen.2016.08.006

scholarly journals A Hormonally Active Malignant Struma Ovarii

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Carolina Lara ◽  
Dalia Cuenca ◽  
Latife Salame ◽  
Rafael Padilla-Longoria ◽  
Moisés Mercado
Keyword(s):  
Thyroid Hormone ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Ovarian Teratoma ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Malignant Struma Ovarii

Struma ovarii is a rare monodermal variant of ovarian teratoma that contains at least 50% thyroid tissue. Less than 8% of struma ovarii cases present with clinical and biochemical evidence of thyrotoxicosis due to ectopic production of thyroid hormone and only 5% undergo malignant transformation into a papillary thyroid carcinoma. Only isolated cases of hormonally active papillary thyroid carcinoma developing within a struma ovarii have been reported in the literature. We report the case of a 36-year-old woman who presented with clinical signs and symptoms of hyperthyroidism as well as a left adnexal mass, which proved to be a thyroid hormone-producing, malignant struma ovarii.

scholarly journals Diagnostic importance of CD56 with fine-needle aspiration cytology in suspected papillary thyroid carcinoma cases

CytoJournal ◽  
2018 ◽  
Vol 15 ◽  
pp. 3 ◽  
Author(s):  
Ozgen Arslan Solmaz
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Histopathological Examination ◽  
Adult Population ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle

Background: Palpable thyroid nodules can be found in 4%–7% of the adult population; however, <5% of thyroid nodules are malignant. Immunohistochemical markers, such as CD56, can be used to make a differential diagnosis between benign and malignant lesions. To increase the accuracy of the diagnosis and distinguish the malignant aspirates from the benign ones, chose to evaluate CD56, which is normally found in benign thyroid tissue. Methods: A total of 53 fine-needle aspirate samples from patients diagnosed with suspected papillary thyroid carcinoma (PTC) were included prospectively. These aspirates were immunocytochemically stained for CD56. Results: In histopathological examination, the fine-needle aspiration cytopathology specimens suspicious for PTC (after undergoing surgery) showed that 32 (60.4%) were benign and 21 (39.6%) were malignant. Thirty-one of the benign cases (96.87%) were CD56-positive, whereas the last case (3.13%) was CD56-negative. Staining was not seen in any of the malignant cases. Conclusions: We believe that CD56 is an important marker in the definitive diagnosis of suspected PTC cases, with CD56-positivity being interpreted in favor of benignity.

scholarly journals SUN-481 A Coexisting Primary Papillary Thyroid Carcinoma in a Case of Malignant Struma Ovarii with Follicular Thyroid Carcinoma: 2 Types of Thyroid Cancer in the Same Patient

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ghada Elshimy ◽  
Richa Bhattarai ◽  
Kelvin Tran ◽  
Ricardo Rafael Correa
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Follicular Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Follicular Carcinoma ◽  
Good Prognosis ◽  
Struma Ovarii ◽  
Malignant Struma Ovarii ◽  
Lymph Node Sampling ◽  
Aortic Lymph Node

Abstract Introduction: Struma ovarii is a rare monodermal variant of ovarian teratoma diagnosed when thyroid tissue is more than 50% of the overall tissue. It represents only 1% of all ovarian tumors. The vast majority of struma ovarii are benign (95%); however, malignant tumors have been reported in a small percentage of cases. The most common type is papillary carcinoma(PTC), followed by typical follicular carcinoma found in the pathology after surgical oophorectomy. We report a case of malignant struma ovarii with follicular carcinoma in the setting of additional micro PTC found after total thyroidectomy. Case report: A 48-year-old female presented with right-sided pelvic pain and a mobile pelvic mass. Pelvic MRI showed noted a large complex solid mass with cystic components in the right adnexa. It measured 7.7 x 8.4 x 6.7 cm. Subsequently, the patient underwent a robotic hysterectomy, bilateral salpingo-oophorectomy (TAHBSO), bilateral pelvic and para-aortic lymph node sampling, omentectomy and resection of nodules. Final pathology noted an ovary with struma ovarii with well-differentiated follicular carcinoma, peritoneal nodules containing thyroid tissue and benign lymph nodes. Subsequently, iodine 123 SPECT CT showed physiologic uptake in the thyroid with increased uptake in the pelvis, right perirectal region indicating residual thyroid tissue. The patient underwent total thyroidectomy with radioactive ablation with I131 (154.7 mCi). Pathology detected incidental 0.5mm micro PTC and it was classified as staged pT1aN. 6 months postoperatively, thyroglobulin (Tg) and Tg antibodies were undetectable with no abnormalities found on repeat whole-body scans. The patient has been following up with no new issues for the past 5 years indicating a good prognosis with low risk of recurrence. Discussion and Conclusion: In the literature, Struma ovarii containing thyroid-type carcinoma and papillary or follicular thyroid carcinoma metastasizing to the ovary has been documented. The standard treatment of a patient with malignant struma ovarii is TAHBSO and complete surgical staging, including peritoneal washings for cytology, pelvic and para-aortic lymph node sampling, and omentectomy. In cases with the residual malignant disease after surgery, total thyroidectomy and radioactive ablation are recommended. Our case is a unique case given the presence of 2 different thyroid carcinoma in the same patient. In addition, our patient had multiple risk factors for recurrence including large lesions&gt;4 cm, extra ovarian extension, and the coexisting synchronous primary thyroid cancer, however, she had a good prognosis with no recurrence during the 5 years follow up period.

scholarly journals Poorly Differentiated Thyroid Carcinoma Arising in Struma Ovarii

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Surapan Khunamornpong ◽  
Jongkolnee Settakorn ◽  
Kornkanok Sukpan ◽  
Prapaporn Suprasert ◽  
Sumalee Siriaunkgul
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Carcinoma ◽  
Ovarian Neoplasms ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Struma Ovarii ◽  
Poorly Differentiated Thyroid Carcinoma ◽  
Poorly Differentiated

Struma ovarii is an uncommon type of ovarian mature teratoma with a predominant thyroid component. The morphological spectrum of the thyroid tissue ranges from that of normal thyroid to proliferative adenoma-like lesions and thyroid-type carcinomas (malignant transformation). The histologic features of ovarian strumal lesions sometimes cause diagnostic problems due to the confusion with other types of ovarian neoplasms and the difficulty in the prediction of their clinical behavior. We report an extremely rare case of poorly differentiated thyroid carcinoma arising in struma ovarii. A 22-year-old woman presented with a 15 cm right ovarian mass. The tumor showed a predominantly tubular pattern which raised a differential diagnosis between endometrioid adenocarcinoma and Sertoli cell tumor. A review of the gross specimen with additional tissue sampling helped identify the teratomatous and strumal nature, with a support by immunohistochemical staining. Despite FIGO stage IA by optimal staging procedure and the absence of identifiable lymphovascular invasion, the patient developed pulmonary metastasis 15 months after surgery and died from the progression of the disease 7 years after the diagnosis. This case emphasizes the importance of macroscopic examination of the specimen and the awareness of this uncommon tumor in the differential diagnosis of ovarian neoplasms.

Synchronous malignant struma ovarii and papillary thyroid carcinoma

2016 ◽  
Vol 63 (7) ◽  
pp. 366-367
Author(s):  
Pablo Fernández Catalina ◽  
Antonia Rego Iraeta ◽  
Mónica Lorenzo Solar ◽  
Paula Sánchez Sobrino
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Malignant Struma Ovarii

Malignant Struma Ovarii with Papillary Thyroid Carcinoma: Case Report

2020 ◽  
Vol 46 (2) ◽  
pp. e110
Author(s):  
Ana Paulina Melendez ◽  
Ana Gabriela Gongora ◽  
Anait Abad ◽  
Eugenio Abreu ◽  
Alejandro Martinez
Keyword(s):  
Case Report ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Malignant Struma Ovarii

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

Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 45 ◽  
Author(s):  
Agnieszka Gonet ◽  
Rafał Ślusarczyk ◽  
Danuta Gąsior-Perczak ◽  
Artur Kowalik ◽  
Janusz Kopczyński ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Histopathological Examination ◽  
Thyroid Tissue ◽  
Histopathological Diagnosis ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Preoperative Serum ◽  
Therapeutic Decisions

Introduction: Struma ovarii accounts for 2% of mature teratomas. Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. Malignant transformation is rare, occurring in <5% of struma ovarii cases. Case presentation: A 17-year-old patient was diagnosed with papillary thyroid cancer in struma ovarii. The patient exhibited menstrual disorders. Abdominal and pelvic CT revealed a 17 cm mass in the left adnexa. Laparoscopic removal of the left adnexa with enucleation of right ovarian cysts was performed. Histopathological diagnosis was a follicular variant papillary carcinoma measuring 23 mm in diameter. Immunohistochemical positive expression of CK19, TTF-1, and thyroglobulin (Tg) confirmed the diagnosis. Molecular analysis detected the BRAF K601E mutation in ovarian tumor tissues. Preoperative serum Tg concentration was >300 ng/mL, which decreased to 38.2 ng/mL after gynecological surgery with undetectable anti-Tg antibodies. The patient underwent total thyroidectomy with no cancer detected on histopathological examination. The patient was treated with I-131 and showed no recurrence 4 years after the diagnosis. Conclusions: Malignant struma ovarii is diagnosed by surgery. Because papillary carcinoma in struma ovarii is rare and there are no guidelines regarding the management of this type of cancer, therapeutic decisions should be made individually based on clinical and pathological data.

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