Management of malignant struma ovarii: is aggressive therapy justified? Case report and literature review

Thyroid Research - Tập 15 Số 1
Letiţia Leuştean1, Maria-Christina Ungureanu1, Cristina Preda1, Ştefana Bîlha1, Florin Obrocea2, Radu Dănilă3, Laura Stătescu4, Delia Ciobanu5
1Department of Endocrinology, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iasi, Romania
2Green Onco-Medical Bucuresti, București, Romania
3Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iasi, Romania
4Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iasi, Romania
5Department of Pathology, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iasi, Romania

Tóm tắt

Abstract Background Struma ovarii (SO) is a rare ovarian teratoma containing predominantly thyroid tissue. In rare situations SO may develop malignancy. Most cases of malignant struma ovarii (MSO) are diagnosed after surgical removal, based on histopathological examination. There are still controversies regarding the extent of surgery and postoperative management in MSO, due to its unpredictable behavior, possible risk of metastasis and relatively high rate of recurrence. Case Presentation We present the case of a patient diagnosed with a right ovarian cyst discovered incidentally during routine ultrasound examination. Its rapid growth and pelvic MRI raised the suspicion of a neoplastic process. She underwent total hysterectomy and bilateral adnexectomy. The anatomopathological diagnosis was MSO with follicular variant of papillary thyroid carcinoma. Prophylactic total thyroidectomy was performed, followed by radioactive iodine ablation (RAI), and suppressive therapy with levothyroxine. At 1 year follow-up, the patient was disease free. Conclusions Even if latest literature reports consider that completion of local surgery with total thyroidectomy and RAI might be too aggressive in cases of MSO without extraovarian extension, in our case it was decided to follow the protocol for primary thyroid carcinoma, in order to reduce the recurrence risk.

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Tập 15 Số 1

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