ECE2016 Eposter Presentations Clinical case reports - Thyroid/Others (71 abstracts)
Management dilemma in papillary carcinoma arising from struma ovarii
Ana Hreniuc 1 , Simona Gherasim 1 , Cristina Preda 1, , Maria-Christina Ungureanu 1, , Carmen Vulpoi 1, , Voichita Mogos 1, , Doina Piciu 4 , Radu Danila 3, & Letitia Leustean 1,
1Department of Endocrinology, St. Spiridon Hospital, Iasi, Romania; 2University of Medicine and Pharmacy, Gr. T. Popa, Iasi, Romania; 3Department of Surgery, St. Spiridon Hospital, Iasi, Romania; 4Department of Radiotherapy, Oncological Institute” Prof. Dr Ion Chiricuta”, Cluj-Napoca, Romania.
A rare ovarian teratoma consisting mainly of thyroid tissue, Struma ovarii accounts for up to 3% of all ovarian tumors. The thyroid tissue may demonstrate the same spectrum of pathological features as in the normal thyroid including benign and malignant changes.
A 46-year-old woman was referred to our clinic in July 2015 by the oncologist, with the diagnosis of struma ovarii with carcinomatous transformation (follicular variant of papillary carcinoma).
The patient known with morbid obesity, candidate for gastric sleeve surgery, had been followed up for about one year for a right ovarian cyst of 44/34 mm revealed at the preoperative echography. Further follow-up IRM examination showed an increased cyst volume-79/66/72 mm and her CA 125 was slightly elevated at 85 U/ml (0–35 U/ml). At that time, she was euthyroid: TSH=1.21 uIU/ul, fT4=0.94 ng/dl and her anamnesis revealed no sign of hyperthyroidism.
Suspecting a neoplasia, she underwent exploratory laparotomy and total abdominal hysterectomy with bilateral salphingo-oophorectomy On histopathology examination, the large ovarian mass was a Struma ovarii with malignant papillary architecture and thyroid follicles. On immunohistochemistry, the tumor cells were positive for TTF1.
Subsequently, the patient underwent prophylactic total thyroidectomy followed by the administration of 90 mCi of 131I therapy. The WBS examination showed small uptake in the area of the right ovary. The Tg values were in normal range-0.04 ng/ml (<0.04 ng/ml) under the administration of a suppressive dose of L-thyroxine. A pelvic IRM investigation was asked to complete our investigation and a close follow-up will establish the management in this rare disease.
Case particularities: Being this fairly uncommon tumor there is a lack of diagnostic and treatment guidelines. The management of the struma ovarii like any other thyroid cancer permitted us the attentive follow up of eventual secondary disseminations.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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