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>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.

Missed Initial Diagnosis of Malignant Struma Ovarii Containing Follicular Thyroid Carcinoma

2015 ◽  
Vol 34 (5) ◽  
pp. 445-449 ◽  
Author(s):  
Hui Cong ◽  
Tianjun Li ◽  
Ge Chen ◽  
Zhiyong Liang ◽  
Jun Liang ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Follicular Thyroid Carcinoma ◽  
Initial Diagnosis ◽  
Struma Ovarii ◽  
Malignant Struma Ovarii

scholarly journals Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Luca Giovanella ◽  
Fabrizio Fasolini ◽  
Sergio Suriano ◽  
Luca Mazzucchelli
Keyword(s):  
Thyroid Carcinoma ◽  
Follicular Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Thyroid Tissue ◽  
Follicular Carcinoma ◽  
First Case ◽  
Right Lobe ◽  
Rare Malignancy ◽  
The Right ◽  
Trabecular Carcinoma

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the -pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

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 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 MON-440 Unusual Case of Metastatic Struma Ovarii Diagnosed at the Time of Hysterectomy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jennifer Merrill ◽  
Sara Ahmadi ◽  
Jennifer Perkins
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Whole Body ◽  
Ovarian Teratoma ◽  
Thyroid Ultrasound ◽  
Struma Ovarii ◽  
Follicular Variant ◽  
Malignant Struma Ovarii

Abstract Introduction: Struma ovarii is rare ovarian teratoma composed of more than 50% mature thyroid tissue, which can rarely transform to malignancy. There are fewer than 200 cases reported and no established treatment approach. We present a case of metastatic malignant struma ovarii. Case Presentation: A 41 year old female was diagnosed with metastatic papillary thyroid carcinoma (PTC) after it was found on uterine histopathology. History was notable for remote left ovarian cystectomy of a mature teratoma with prominent thyroid component. She had no personal or family history of craniocervical radiation or thyroid cancer. Eight years later, she had a total hysterectomy for menorrhagia. Pathology showed subcentimeter serosal deposits of follicular variant PTC, staining positive for thyroglobulin, CK19, and HBME1. Endometrial and cervical pathology were normal; the myometrium had many leiomyomata. Post-hysterectomy TSH was 2.3 (0.34 - 5.66 µIU/mL), and thyroglobulin 44.3 (<=33.0 ng/mL). Thyroid ultrasound showed a 7 mm isoechoic nodule without lymphadenopathy. Whole body PET/CT showed multiple hypermetabolic masses in the pelvic peritoneum and liver. The right ovary had many cystic lesions and was enlarged to 5.3 x 4.5 cm. She underwent partial hepatectomy, oophorectomy, salpingectomy, and omental resection with no residual disease. Pathology showed follicular variant PTC in both ovaries, peritoneum, colonic mesentery, and omentum. Thyroglobulin fell to 6.9 ng/mL 3 weeks later. A 0.2 cm focus of follicular variant PTC with capsular invasion was found on pathology after total thyroidectomy. She underwent radioiodine ablation with 150 mCi. Postablative scan showed residual activity in the thyroid bed and right hemipelvis, but no new foci of activity. CT abdomen showed resolution of perihepatic lesions and thyroglobulin declined further to 0.5 ng/mL. Discussion: A low risk of recurrence (7.5%) has been reported in patients with malignant struma ovarii, with survival rates of 96.7% at 5 years and 84.9% at 20 years, despite a variety of surgical and adjuvant management strategies. Unilateral cystectomy, unilateral salpingo-oophorectomy, or total abdominal hysterectomy and bilateral salpingo-oophorectomy may be sufficient for patients with well differentiated thyroid cancer arising in struma ovarii without metastases. Thyroid ultrasound should be performed to exclude primary thyroid malignancy. Patients with distant metastases may benefit from aggressive treatment including resection of gross abdominal and pelvic disease and total thyroidectomy to facilitate radioactive iodine ablation and surveillance for recurrence. Conclusion: Due to its rarity, there is no consensus on optimal treatment of malignant struma ovarii. More research in this field is warranted.

scholarly journals Spinal cord compression as initial presentation of metastatic occult follicular thyroid carcinoma

2014 ◽  
Vol 5 (02) ◽  
pp. 155-159 ◽  
Author(s):  
Md Nuruzzaman Khan ◽  
AMSM Sharfuzzaman ◽  
Md Golam Mostafa
Keyword(s):  
Spinal Cord ◽  
Thyroid Carcinoma ◽  
Spinal Cord Compression ◽  
Follicular Thyroid Carcinoma ◽  
Follicular Carcinoma ◽  
Cord Compression ◽  
Good Prognosis ◽  
Initial Presentation ◽  
Radioiodine Ablation ◽  
Thyroid Profile

ABSTRACTMetastatic tumors are the most common tumors of the spine, accounting for 98% of all spine lesions. But spinal cord compression as the initial presentation of metastatic occult follicular carcinoma without any thyroid enlargement is unusual and relatively rare. This report describes a 35-years-old female patient presenting with paraplegia and urinary incontinence for the last two months. She had no thyroid enlargement; no thyroid related symptoms and her biochemical thyroid profile was normal. Magnetic resonance imaging (MRI) of spine shows a huge mass compressing the spinal cord at D11-D12 involving both the spinal and paraspinal areas. The patient was treated by surgery and radioiodine ablation as the histopathology showed metastatic follicular thyroid carcinoma. This case was reported because of the rarity of the disease. Early diagnosis and initiation of the treatment should promise a good prognosis for a patient with metastatic spinal cord compression.

THYROID TYPE CARCINOMA ARISING IN STRUMA OVARII. SIX CLINICAL CASES AND REVIEW

2018 ◽  
Vol 64 (6) ◽  
pp. 708-715
Author(s):  
Natalya Severskaya ◽  
Andrey Rodichev ◽  
Aleksey Ilin ◽  
Dmitriy Semin ◽  
Pavel Isaev ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Clinical Course ◽  
Case Reports ◽  
Thyroid Tissue ◽  
Follicular Carcinoma ◽  
Complete Response ◽  
Pelvic Surgery ◽  
Ovarian Teratoma ◽  
Struma Ovarii

Struma ovarii is a rare variant of the mature ovarian teratoma composed of more than 50% thyroid tissue. Thyroid type carcinoma can occur in 5% of struma ovarii. Given the rarity of this pathology, as well as the different clinical course, approaches to the treatment of this disease are controversial. The proposed approaches to treatment vary from ovarian resection to total hysterectomy with bilateral salpingo-oophorectomy and adjuvant therapy. We present here 6 case reports of thyroid type carcinoma in struma ovarii and outcome of patients treated in our clinic. All patients had pelvic surgery of different extent, followed by thyroidectomy and radioiodine therapy. The incidence of metastasis is 67% (4/6), 2 - intraperitoneal metas-tases, 2 - bone metastases. Among patients with metastases, 2 have reached a complete response, one with a good response continues treatment, one had progression. The follow-up period is 1 to 15 years (median 4 years). One patient with follicular carcinoma died of progression 8 years after diagnosis. The remaining patients are alive.

Use of radioiodine-131 scan to measure influence of surgical discipline, practice, and volume on residual thyroid tissue after total thyroidectomy for differentiated thyroid carcinoma

Head & Neck ◽  
2018 ◽  
Vol 40 (10) ◽  
pp. 2129-2136 ◽  
Author(s):  
Jin Soo A. Song ◽  
Nico Moolman ◽  
Steven Burrell ◽  
Murali Rajaraman ◽  
Martin Joseph Bullock ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma

Malignant Clinical Course of Histologically Benign Ovarian Struma: case report and literature review

2021 ◽  
Author(s):  
Aleksandra Asaturova ◽  
A. Magnaeva ◽  
A. Tregubova ◽  
V. Kometova ◽  
E. Karamurzin ◽  
...  
Keyword(s):  
Case Report ◽  
Ovarian Tumor ◽  
Clinical Course ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Follicular Carcinoma ◽  
Struma Ovarii ◽  
Diagnostic Challenge ◽  
Laboratory Findings ◽  
Metastatic Lesions

Abstract BackgroundStruma ovarii is a variant of monodermal teratoma, consisting of morphologically benign, atypical, or frankly malignant thyroid tissue. Morphologic features may or may not correlate with biologic behavior. Albeit this case report is not unique, ovarian tumor developed with peritoneal dissemination and bone metastasis, which is highly unlikely clinical complication. Additionally, we summarized previously cases of struma ovarii with an emphasis on correlation between morphological appearances, clinical course and providing treatment. Case presentationWe present the 38-year-old patient who was hospitalized for ovarian tumor. The diagnostic laparoscopy revealed lesions of peritoneum, sigmoid serosa and omentum and left ovarian mass. We diagnosed left ovarian mature teratoma without struma tissue and metastatic lesions with struma morphology which can be related to her history of left ovarian struma in 2016. Taking into account the metastatic lesions revealed in 2020, the tumor removed in 2016 was assessed as highly differentiated follicular carcinoma arising in struma ovarii. ConclusionsPrediction of biologic behavior of struma ovarii is still to be to diagnostic challenge, therefore multidisciplinary approach including clinical a n d laboratory findings, radiologic details and histopathological features is required. Providing additional data, the present case report contributes to expending the knowledge of these peculiar neoplasms.

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