Document Detail

Lethal, malignant, metastatic struma ovarii.
MedLine Citation:
PMID:  20825300     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Struma ovarii (SO) is extremely rare, with less than 200 reported cases in the medical literature. SO is defined by the presence of an ovarian tumor containing thyroid tissue as the predominant cell type. Malignant transformation is rare and lethal cases of SO are even rarer. We report on a patient presenting with left ovarian cystic SO and lethal outcome.
SUMMARY: A 45-year-old woman was diagnosed with a follicular variant of papillary carcinoma on laparotomy and left salpingo-oophorectomy. She had persistently elevated serum thyroglobulin following total thyroidectomy + radioiodine and second-look surgery. Imaging scan analysis showed pelvic tumor recurrence and hypervascular liver metastases during follow-up as well as peritoneal carcinomatosis in the pelvis, right abdominal wall, and malignant ascites. The patient died from cachexia at 37 months after diagnosis.
CONCLUSIONS: Such an aggressive malignant disease and lethal course of SO is rare. Total thyroidectomy is mandatory to exclude a primary thyroid neoplasm and for radioiodine therapy and follow-up. SO may spread to contralateral ovary, pelvic nodes, peritoneum, liver, lungs, and bones through hematogeneous spread, which is different from the dissemination pattern of papillary thyroid carcinomas. Imaging highlights the mixed behavior of this ovarian tumor.
Pierre-Yves Marcy; Juliette Thariat; Danielle Benisvy; Pierre Azuar
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  20     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1037-40     Citation Subset:  IM    
Department of Head and Neck Imaging, Antoine Lacassagne Cancer Research Center, Nice, France.
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MeSH Terms
Cachexia / metabolism
Carcinoid Tumor / diagnosis*
Fatal Outcome
Iodine Radioisotopes / therapeutic use
Liver Neoplasms / radiography,  secondary
Middle Aged
Ovarian Neoplasms / diagnosis*
Pelvic Neoplasms / radiography,  secondary
Peritoneal Neoplasms / radiography,  secondary
Second-Look Surgery
Struma Ovarii / diagnosis*
Thyroglobulin / blood
Reg. No./Substance:
0/Iodine Radioisotopes; 9010-34-8/Thyroglobulin

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