Endocrine Abstracts

We report two rare cases of well differentiated thyroid-type carcinoma arising from struma ovarii managed in our institution.

Case 1: A 41-year-old female admitted due to abdominal pain and vomiting. Her abdomen was globular with palpable vague mass on lower abdomen. Ultrasound scan revealed 12.5×12.1×8.3 cm heterogenous mass with ascites. Total abdominal hysterectomy with bilateral salphingo-oophorectomy was done and histopathology results revealed papillary thyroid-type carcinoma arising from struma ovarii. Total thyroidectomy, radioactive iodine ablation and thyroxine suppression therapy were done. On follow-up there was no evidence of persistent tumor or recurrences.

Case 2: A case of 38-year-old, G3P2, female diagnosed with 16×15×12 cm cystic ovarian mass during the second trimester of her third pregnancy, underwent right salphingo-oophorectomy due to persistent abdominal pain. Histopathology revealed follicular carcinoma of thyroid type with no metastases. Further treatment of the malignancy was delayed due to current pregnancy. Patient delivered a healthy appropriate for gestational age baby boy via a spontaneous vaginal delivery. She is now scheduled to undergo thyroidectomy, radioactive ablationa and thyroxine suppressive therapy.

Due to the rarity of the disease, protracted clinical course and lack of uniform histological criteria for malignancy, diagnosis and management are still not universally accepted. Recent recommendations showed that well differentiated thyroid-type carcinoma arising from stuma ovarii as presented in our two cases should be diagnosed and managed as primary well differentiated carcinoma of thyroid gland.