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A rare case of a struma ovarii and carcinoid of the ovary is presented. In comparison with 21 reported cases, the tumor was unilateral and showed no metastatic spread. The treatment of this primary ovarian tumor with low malignant potential, was bilateral salpingo-oophorectomy and hysterectomy. Long-term follow up is advisable.
A case of struma ovarii with ascites and hydrothorax is reported. This unusual rare association is labeled as pseudo-Meigs' syndrome to differentiate it from conventional Meigs' syndrome in which the ovarian tumor is a fibroma. We discuss the diagnostic problems of this condition, and present a brief review of the reported cases in the literature.
A 36-year-old woman presented with an intraperitoneally disseminated malignant struma ovarii, diagnosed by histopathology and 131I scintigraphy. The serum thyroglobulin level was elevated, and immunoperoxidase staining for thyroglobulin was positive for disease both in the tumor cells lining the follicles and in the colloid. The patient was treated successfully by a bilateral ovariectomy followed by a total thyroidectomy and administration of radioactive iodine. The clinical behavior and the presence of thyroglobulin in both serum and tumor tissue demonstrate the similarity between neoplastic thyroid tissue in the ovary and in the thyroid gland.
The case is reported of a patient with a mixed lesion composed of struma ovarii and Brenner tumour. This is an extremely rare tumour and only two well documented cases were found in the English literature.
A 42-yr-old woman had a solitary metastases to her spine (T2) from a malignant struma ovarii. The thyroid was excluded as the site of the primary cancer. The lesion caused paraparesis. The spinal metastasis was treated by surgery and two doses of 131I (200 mCi each time). The patient responded very well and is entirely free of symptoms and signs. Repeat whole-body 131I scan shows no abnormality.
This report discusses the limitations of using the serum tumour marker CA 125 in the preoperative evaluation of a woman presenting with a pelvic mass. We present 2 cases of benign struma ovarii which were associated with elevated levels of CA 125.
The present report describes a case of a proliferative lesion developed in a struma ovarii of a 26-year-old woman who presented with asymptomatic bilateral mature ovarian teratomas. The tumor immunohistochemically and ultrastructurally proved to be an oxyphilic follicular thyroid tumor. Although it showed some histologic features which could raise a suspicion of malignancy (solid, trabecular pattern and nuclear pleomorphism), no unequivocable signs of aggressive behaviour (high mitotic activity and vascular invasion) were evidence. The patients was alive and well 1 year after a bilateral subtotal ovariectomy.
A 43-year old women was admitted to our hospital for investigation and treatment of a right ovarian tumour. Presenting symptoms and signs included recurrent pelvic pain since half a year, nervousness and intercurrent insomnia. At operation a solid cystic tumour was found arising from the right ovary. Histologically a combination tumour was found to consist of a multilocular cystadenoma and a true struma ovarii as a rare neoplasia of teratomatous nature.
A case of hyperthyroid disease after total thyroidectomy is reported. An initial scintigraph with Tc-99m sodium pertechnetate confirmed the absence of uptake in the neck. The view of the pelvis revealed a rounded area of increased uptake on the left, near the sacroiliac joint (results of bone scintigraphy were negative). A wholebody scan with iodine-131 confirmed a struma ovarii that was bilateral, which occurs in 5% to 10% of patients with this condition.
BACKGROUND: There has been controversy regarding the histogenesis of Brenner tumors. It is generally accepted that Brenner tumors are derived directly from ovarian surface epithelium, which undergoes metaplasia to form the typical urothelial-like components, whereas some investigators assume that Brenner tumors arise from immature germ cells. CASE: We describe a well-documented case of the coexistence of struma ovarii regarded as a form of teratoma and Brenner tumor in the same ovary. Immunohistologically, not only columnar cells of thyroid follicles, but also transitional cells of Brenner nests were positive for thyroglobulin. CONCLUSIONS: In the present case, Brenner tumors and thyroid elements coexisted and were positive for thyroglobulin. While there is strong evidence that pure Brenner tumors originate mostly from the ovarian surface, at least Brenner tumors associated with teratomatous elements may have a germ cell origin.
A 46-year-old women was examined for severe constipation. Pelvic examination revealed a large pelvic mass extending to the level of the umbilicus. Computed tomography showed a large multicystic, septated mass in the pelvis and a small amount of fluid in the cul de sac. In addition, multiple ill-defined, mixed-attenuation hepatic lesions were identified. A malignant ovarian neoplasm with liver metastases was considered, so the pelvic mass was resected. Interestingly, histopathologic analysis revealed malignant struma ovarii of the follicular type. Biopsy of the liver lesions confirmed metastatic disease with similar histopathologic findings. All thyroid laboratory values were in the normal range. The patient then had a total thyroidectomy to optimize thyroid ablation therapy with I-131. This revealed a small follicular adenoma but no evidence of cancer. An I-131 whole-body scan was performed and showed uptake in multiple functioning liver metastases.
We recently encountered a unique case of follicular variant of papillary carcinoma arising in struma ovarii that contained numerous intrafollicular crystalloids. There was no evidence of capsular or vascular invasion or metastases, though the DNA content of the papillary carcinoma was aneuploid. In contrast, diploid DNA was manifested in the histologically benign thyroid tissue. The nature of the crystalloids and the significance of aneuploid DNA content are discussed.
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The purpose of our study was to evaluate the Doppler flow characteristics of ovarian dermoid cysts. In 70 women (mean age, 38.7 +/- 14.6 years), 78 ovarian lesions with mean diameter of 48.9 +/- 28.4 mm and preoperative sonographic diagnosis of dermoid cyst of the ovary were evaluated prospectively by Doppler flow sonography; these cysts were eventually removed surgically. The findings were compared to the postoperative histologic results. In 74 lesions (eight cases were bilateral), when blood flow patterns were detected (detection rate of 24.3%) they were obtained only from the ovarian tissue surrounding the dermoid cavity, with a mean resistive index of 0.6 +/- 0.1 (range, 0.4 to 0.76). In four cases, which were proved postoperatively to be struma ovarii, blood flow was detected not only from the cyst capsule but also from the centrally positioned solid area (dermoid tissue), with a mean RI of 0.565 +/- 0.08 (range, 0.509 to 0.667). Dermoid cysts of the ovary are devoid of blood flow, with flow detection rate being only 24.3% from the cyst capsule. When apparently vascularized solid tissue is detected in the central part of a sonographically suspected benign cystic teratoma, struma ovary is highly suspected.
Seven ovarian tumours (3 mature teratomas, 2 strumas with malignancy 2 strumal carcinoids) have been examined histologically, hystochemically and electron-microscopically. It is shown that the cell composition of the strumal teratoma tissue is very similar to that of the ectopic thyroid. The follicular cells may proliferate either into the benign tumour (apudoma) or typical thyroid carcinoma. Parafollicular cells may give rise to C-cell hyperplasia with the amyloid deposits in the stroma. The so-called strumal carcinoid of the ovary represents probably the C-cell tumour. Its "strumal" component may be considered as preexisting follicles invaded by tumour apudocytes or as the site of tumour origin displaying the pattern of a non-medullary thyroid apudoma.