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.

scholarly journals Malignant Struma Ovarii with Concurrent Thyroid Cancer: Outcomes during and after Pregnancy

2021 ◽  
pp. 1-5
Author(s):  
Sara Donato ◽  
Helder Simões ◽  
Valeriano Leite
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Tissue ◽  
Pelvic Mass ◽  
Pregnant Patient ◽  
Whole Body ◽  
Ovarian Teratoma ◽  
Struma Ovarii ◽  
Pelvic Mri ◽  
Biochemical Evidence

<b><i>Introduction:</i></b> Struma ovarii (SO) is a rare ovarian teratoma characterized by the presence of thyroid tissue in more than 50% of the tumor. Malignant transformation is rare and the most common associated malignancy is papillary thyroid carcinoma (PTC). Pregnancy may represent a stimulus to differentiated thyroid cancer (DTC) growth in patients with known structural or biochemical evidence of disease, but data about malignant SO evolution during pregnancy are rare. We present the first reported case of a pregnant patient with malignant SO and biochemical evidence of disease. <b><i>Case Presentation:</i></b> A previously healthy 35-year-old female diagnosed with a suspicious left pelvic mass on routine ultrasound was submitted to laparoscopic oophorectomy which revealed a malignant SO with areas of PTC. A 15-mm thyroid nodule (Bethesda V in the fine-needle aspiration cytology) was detected by palpation and total thyroidectomy was performed. Histology revealed a 15 mm follicular variant of PTC (T1bNxMx). Subsequently, she received 100 mCi of radioactive iodine therapy (RAIT) with the whole-body scan showing only moderate neck uptake. Her suppressed thyroglobulin (Tg) before RAI was 1.1 ng/mL. She maintained biochemical evidence of disease, with serum Tg levels of 7.6 ng/mL. She got pregnant 14 months after RAIT, and during pregnancy, Tg increased to 21.5 ng/mL. After delivery, Tg decreased to 14 ng/mL but, 6 months later, rose again and reached 31.9 ng/mL on the last follow-up visit. TSH was always suppressed during follow-up. At the time of SO diagnosis, a chest computed tomography scan showed 4 bilateral lung micronodules in the upper lobes which were nonspecific, and 9 months after diagnosis, a pelvic MRI revealed a suspicious cystic nodule located on the oophorectomy bed. These lung and pelvic nodules remained stable during follow-up. Neck ultrasonography, abdominal MRI, and fluorodeoxyglucose-positron emission tomography showed no suspicious lesions. <b><i>Discussion/Conclusion:</i></b> As for DTC, pregnancy seems to represent a stimulus to malignant SO growth. This can be caused by the high levels of estrogen during pregnancy that may bind to receptors in malignant cells and/or by the high levels of hCG which is known to stimulate TSH receptors.

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.

scholarly journals Struma ovarii: two case reports of a rare teratoma of the ovary

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Obed Rockson ◽  
Christine Kora ◽  
Abdelbassir Ramdani ◽  
Aabdi Basma ◽  
Tariq Bouhout ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Case Reports ◽  
Thyroid Tissue ◽  
Ovarian Teratoma ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Struma Ovarii ◽  
Rare Type ◽  
Benign Condition ◽  
First Case

Abstract Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. It is usually a benign condition; however, malignant transformation is sometimes detected. The diagnosis relies on histopathological examination and is infrequently made on routine investigations. We report two cases of struma ovarii: one benign and the other malignant. The first case involved a 27-year-old woman who underwent a right ovarian cystectomy for an incidental ultrasonographic finding of a solid right adnexal mass. The diagnosis of a benign struma was made after histopathological study. The second case involved a 68-year-old woman who underwent a right salpingo-oophorectomy for a right ovarian bulky mass and the histopathological diagnosis was consistent with that of a malignant struma. We examine the challenges involved in the diagnosis and management of this rare entity.

scholarly journals Metastatic malignant struma ovarii with coexistence of Hashimoto’s thyroiditis

2016 ◽  
Vol 2016 ◽  
Author(s):  
Marco Russo ◽  
Ilenia Marturano ◽  
Romilda Masucci ◽  
Melania Caruso ◽  
Maria Concetta Fornito ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Risk Stratification ◽  
Thyroid Tissue ◽  
Surgical Excision ◽  
Disease Diagnosis ◽  
Ovarian Teratoma ◽  
List Type ◽  
Struma Ovarii ◽  
Malignant Struma Ovarii

Summary Struma ovarii is a rare ovarian teratoma characterized by the presence of thyroid tissue as the major component. Malignant transformation of the thyroidal component (malignant struma ovarii) has been reported in approximately 5% of struma ovarii. The management and follow-up of this unusual disease remain controversial. We report the case of a woman with a history of autoimmune thyroiditis and a previous resection of a benign struma ovarii that underwent hystero-annexiectomy for malignant struma ovarii with multiple papillary thyroid cancer foci and peritoneal involvement. Total thyroidectomy and subsequent radioiodine treatment lead to complete disease remission after 104 months of follow-up. The diagnosis and natural progression of malignant struma ovarii are difficult to discern, and relapses can occur several years after diagnosis. A multidisciplinary approach is mandatory; after surgical excision of malignant struma, thyroidectomy in combination with 131I therapy should be considered after risk stratification in accordance with a standard approach in differentiated thyroid cancer patients. Learning points Malignant struma ovarii is a rare disease; diagnosis is difficult and management is not well defined. Predominant sites of metastasis are adjacent pelvic structures. Thyroidectomy and 131I therapy should be considered after risk stratification in accordance with standard approaches in DTC patients.

Malignant thyroid teratoma: an integrated analysis of case series and case reports

2021 ◽  
Author(s):  
Huy Gia Vuong ◽  
Truong P.x. Nguyen ◽  
Hanh T.t. Ngo ◽  
Lewis Hassell ◽  
Kennichi Kakudo
Keyword(s):  
Clinical Course ◽  
Case Reports ◽  
Case Series ◽  
Seer Program ◽  
Integrated Analysis ◽  
Continuous Variables ◽  
Chi Square ◽  
Large Tumor ◽  
Exact Test

Malignant thyroid teratoma (MTT) is a very rare thyroid malignancy. These neoplasms have been reported only in case reports and small-sized case series so far. In this study, we searched for MTTs in the Surveillance, Epidemiology, and End Result (SEER) program during 1975-2016. Subsequently, we incorporated the SEER data with published MTT cases in the literature to analyze the characteristics and prognostic factors of MTTs. Integrated data were analyzed using Chi-square or Fisher’s exact test for categorical covariates, and t-test or Mann-Whitney test for continuous variables. We included 28 studies with 36 MTT cases and found additional 8 cases from the SEER program for final analyses. Our results showed that MTT is typically seen in adult females. These neoplasms were associated with an aggressive clinical course with high rates of extrathyroidal extension (80%) and nodal involvement (62%). During follow-up, the development of recurrence and metastases were common (42% and 46%, respectively), and one-third of patients died at the last follow-up. Large tumor size (p = 0.022) and the presence of metastases during follow-up (p = 0.008) were associated with a higher mortality rate. In conclusion, our study demonstrated the characteristic features of MTT patients and outlined some parameters associated with a negative outcome which could help clinicians better predict the clinical course of these neoplasms.

scholarly journals ‘Failure’ of laser prophylaxis in an eye with stickler syndrome

2021 ◽  
Vol 11 (4) ◽  
pp. 110-111
Author(s):  
Michael P Blair
Keyword(s):  
Vision Loss ◽  
Clinical Course ◽  
Case Reports ◽  
Visual Outcome ◽  
Stickler Syndrome ◽  
Connective Tissue Disorders ◽  
Macular Function ◽  
Giant Retinal Tear ◽  
Case Summary

Background: Stickler syndrome is one of the most common inherited connective tissue disorders and is an important cause of pediatric vision loss due to a high risk of retinal detachment in these patients. Methods: Case report. Case summary: This case reports describes the clinical course of a 10 year old boy with Sticklers Syndrome who underwent bilateral peripheral laser prophylaxis. During routine follow up, he was found to have an asymptomatic giant retinal tear (GRT) with limited sub-retinal fluid expansion due to prior prophylactic laser. He underwent surgery with vitrectomy and scleral buckle with vision remaining at 20/25 at 6 month follow up. Conclusion: Although the utility of laser prophylaxis in Stickler patients is debated, this case demonstrates that after laser prophylaxis, even if GRT develops, expansion can be limited. Laser prophylaxis along with frequent examinations, can prevent development of PVR and complex detachments and preserve macular function with excellent visual outcome.

scholarly journals Synovial Sarcoma of the Nerve—Clinical and Pathological Features: Case Series and Systematic Review

Neurosurgery ◽  
2019 ◽  
Vol 85 (6) ◽  
pp. E975-E991 ◽  
Author(s):  
Stephen Shelby Burks ◽  
Ross C Puffer ◽  
Iahn Cajigas ◽  
David Valdivia ◽  
Andrew E Rosenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Statistical Analysis ◽  
Synovial Sarcoma ◽  
Tumor Size ◽  
Clinical Course ◽  
Case Reports ◽  
Case Series ◽  
Pathological Features ◽  
Eligibility Criteria

Abstract BACKGROUND Synovial sarcoma of the nerve is a rare entity with several cases and case series reported in the literature. Despite an improved understanding of the biology, the clinical course is difficult to predict. OBJECTIVE To compile a series of patients with synovial sarcoma of the peripheral nerve (SSPN) and assess clinical and pathological factors and their contribution to survival and recurrence. METHODS Cases from 2 institutions collected in patients undergoing surgical intervention for SSPN. Systematic review including PubMed and Scopus databases were searched for related articles published from 1970 to December 2018. Eligibility criteria: (1) case reports or case series reporting on SSPN, (2) clinical course and/or pathological features of the tumor reported, and (3) articles published in English. RESULTS From patients treated at our institutions (13) the average follow-up period was 3.2 yr. Tumor recurrence was seen in 4 cases and death in 3. Systematic review of the literature yielded 44 additional cases with an average follow-up period of 3.6 yr. From pooled data, there were 10 recurrences and 7 deaths (20% and 14%, respectively). Adjuvant treatment used in 62.5% of cases. Immunohistochemical markers used in diagnosis varied widely; the most common are the following: Epithelial membrane antigen (EMA), cytokeratin, vimentin, cluster of differentiation (CD34), and transducin-like enhancer of split 1 (TLE1). Statistical analysis illustrated tumor size and use of chemotherapy to be negative predictors of survival. No other factors, clinically or from pathologist review, were correlated with recurrence or survival. CONCLUSION By combining cases from our institution with historical data and performing statistical analysis we show correlation between tumor size and death.

scholarly journals Serie de Casos: Intoxicación por Amlodipino

2020 ◽  
Vol 12 (2) ◽  
pp. 145-150
Author(s):  
Carlos Fernando Ordoñez Troya ◽  
Giovanni Paolo González Pazmiño ◽  
Lupe Nataly Mora Robles ◽  
María Eduarda Clavijo Izquierdo
Keyword(s):  
Laboratory Tests ◽  
Pediatric Patients ◽  
Clinical Course ◽  
Case Reports ◽  
Treatment Plan ◽  
Low Frequency ◽  
Pediatric Intensive Care ◽  
Evidence Based ◽  
Support Measures

BACKGROUND: Drug poisoning is an important cause of morbidity and mortality in pediatric patients. However, amlodipine poisoning, a widely used dihydropyridine calcium chanel blocker, is not fully documented in Ecuador. Treatment consists of classic measures for shock management and specific measures for this type of intoxication. CASE REPORTS: We present two case reports, both of teenage patients admitted into the pediatric intensive care unit for suicide attempt by taking amlodipine and some other drugs. EVOLUTION: During hospital stay, they presented a different evolutionary course. In both cases vasoactive drugs were needed, dosage was modified according to clinical course. Also in both patients, calcium gluconate was administered along with other support measures described in this paper. Finally, both patients presented a good outcome and were discharged after psychological and psychiatric assessment and follow up. CONCLUSION: The low frequency of amlodipine poisoning and the lack of evidence-based knowledge, constitute it as a diagnostic and therapeutic challenge. Based on our experience, we highlight the importance of early suspicion and prioritizing the use of vasopressors over fluid resuscitation. Additionally, we recommend documenting the exact dose of intake and inquiring about consumption of other drugs to properly classify the severity of the poisoning and stablish the treatment plan. Finally, constant clinical monitoring and support of laboratory tests will guide the conduct.

Thyroid-Type Carcinoma of Struma Ovarii

2010 ◽  
Vol 134 (5) ◽  
pp. 786-791 ◽  
Author(s):  
Xuchen Zhang ◽  
Constantine Axiotis
Keyword(s):  
Radioactive Iodine ◽  
Follicular Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Conservative Surgery ◽  
Abdominal Hysterectomy ◽  
Postoperative Treatment ◽  
Ovarian Teratoma ◽  
Struma Ovarii ◽  
Favorable Prognosis ◽  
Radioactive Iodine Ablation

Abstract Struma ovarii is a monodermal variant of ovarian teratoma. Thyroid-type carcinoma arising in struma ovarii is rare. The most common type is papillary carcinoma, followed by typical follicular carcinoma, and the new entity of follicular carcinoma—highly differentiated follicular carcinoma of ovarian origin; other forms occur rarely. Consensus on the surgical and postoperative treatment of patients with thyroid-type carcinoma arising in struma ovarii has not been reached. Surgical treatment ranges from total abdominal hysterectomy, plus bilateral salpingo-oophorectomy with omentectomy, to conservative surgery, involving unilateral oophorectomy or strumectomy (cystectomy) for fertility preservation. Adjuvant therapy includes external radiotherapy, chemotherapy, thyroidectomy, and radioactive iodine ablation. Thyroid-type carcinomas arising in struma ovarii, especially the newly recognized entity—highly differentiated follicular carcinoma of ovarian origin—have a favorable prognosis.

scholarly journals Blue Rubber Bleb Nevus Syndrome with Long-Term Follow-Up: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Hideaki Nakajima ◽  
Hiroshi Nouso ◽  
Naoto Urushihara ◽  
Koji Fukumoto ◽  
Masaya Yamoto ◽  
...  
Keyword(s):  
Clinical Course ◽  
Case Reports ◽  
Complete Resection ◽  
Review Of The Literature ◽  
Gi Tract ◽  
Short Term ◽  
Long Term Follow Up ◽  
Body Organ

Blue rubber bleb nevus syndrome (BRBNS) is a rare disease in which venous malformations (VMs) involve any body organ, most commonly the skin and the gastrointestinal (GI) tract. Treatment of BRBNS aims at preserving the GI tract as much as possible. Although there are several dozen case reports about BRBNS that describe short-term clinical courses, a few provide an account of long-term clinical course. Here, we report a case of BRBNS in a girl that required multiple abdominal surgeries due to the GI VMs and a recurrence at an interval of 14 years. The preferred approach for gastrointestinal VMs involves the complete resection of all lesions without residual VMs. It is important to bear in mind the possibility of delayed recurrence of GI VMs after surgical or endoscopic treatment.

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