BACKGROUND Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue,accounting for 1%to 3%of all ovarian teratomas and 0.3%to 1.0%of all ovarian tumors.Of which,struma ovarii...BACKGROUND Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue,accounting for 1%to 3%of all ovarian teratomas and 0.3%to 1.0%of all ovarian tumors.Of which,struma ovarii with ascites and pleural effusion,called pseudo-Meigs’syndrome and raised cancer antigen-125levels(CA 125)is even rarer.CASE SUMMARY This paper reports the diagnosis and treatment of a patient of struma ovarii with pseudo-Meigs’syndrome,presenting with the clinical features of ovarian carcinoma:Complex pelvic mass,gross ascites,right pleural effusion and markedly elevated serum CA 125 levels.During the operation,a cystic-solid mass about 20cm×10 cm×5 cm in the right adnexa and a solid mass with the size of 3 cm×2cm×0.1 cm in the left ovary were observed.She underwent right adnexectomy and resection of the left ovarian mass and histopathology revealed a mature leftsided ovarian teratoma and struma ovarii of right adnexal mass.During 1-year follow-up,the patient recovered well,tumor markers and other indicators returned to normal.CONCLUSION The diagnosis and treatment process of this case suggests that the clinical symptoms of struma ovarii with pseudo-Meigs’syndrome are lack specificity,which is easily misdiagnosed.Clinicians should improve the understanding of this disease,enhance the awareness of early screening,and improve the level of diagnosis and treatment.展开更多
BACKGROUND Struma ovarii is a rare specific ovarian tumor.It is a highly differentiated monodermal teratoma with a malignant transformation rate as low as 5%.Thus,malignant transformation and metastasis are extremely ...BACKGROUND Struma ovarii is a rare specific ovarian tumor.It is a highly differentiated monodermal teratoma with a malignant transformation rate as low as 5%.Thus,malignant transformation and metastasis are extremely rare.The clinical manifestations of this disease are not typical and are easily misdiagnosed.CASE SUMMARY A 55-year-old female patient had a history of pain in the right hepatic region for approximately 1 year.Computed tomography and magnetic resonance imaging showed a solid cystic mass in the right adnexal region and a solid mass in the right retroperitoneum.The patient underwent surgical resection,and the combined morphological and immunohistochemical results led to the final diagnosis of right struma ovarii with papillary carcinoma and right retroperitoneal lymph node metastasis.CONCLUSION Malignant struma ovarii with distant metastasis is extremely rare,and the clinical manifestations of this disease are nonspecific.Accurate preoperative diagnoses are difficult to obtain,and pathological examination is the gold standard for diagnosing this disease.展开更多
Struma ovarii, a rare varity of ovarian neoplasm, belongs to the group of monodermic teratomas mainly composed of thyroid tissue. The preoperative diagnosis is always difficult to identify without histopathological ex...Struma ovarii, a rare varity of ovarian neoplasm, belongs to the group of monodermic teratomas mainly composed of thyroid tissue. The preoperative diagnosis is always difficult to identify without histopathological examination. Surgery is the only treatment because malignant alteration is possible and thyroid hyperactivity or hyperthyroidism may occur. Our patient, a post-menopausal women, had unilateral, large, multiloculated ovary mass of 20 cmx 15 cm × 10 cm size without any thyroid hyper activity. The radical excision of the tumor with right ovary was preformed. Histopathological examination confirmed struma ovarii. The post-operative period was uneventful and her thyroid function remained normal.展开更多
Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the mo...Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the most common type of malignant struma ovarii, followed by follicular carcinoma. Malignant struma ovarii is commonly seen in women in the fifth decade. The diagnosis is often made post-operatively after histological examination. Histology also helps assess tumor aggressiveness (mitoses, necrosis, poorly differentiated subtype, etc.). Given the rarity of these lesions, no therapeutic consensus or prognostic value had yet been formally established. We report herein, the case of a 76-year-old woman with a cystic tumor of the right ovary and a nodular lesion of the bladder. The clinical symptomatology is nonspecific, associating abdomino-pelvic pain and a right latero-uterine mass on abdominal palpation. After total hysterectomy with bilateral adnexectomy, the diagnosis of papillary carcinoma arising from struma ovarii and extending into the bladder was made. Through this observation, we suggest to discuss the anatomoclinical particularities of this rare pathological entity.展开更多
A 36-year-old woman with papillary thyroid cancer was diagnosed with a right ovarian mass ultrasono-graphically 2 years earlier.The mass increased in size gradually,and serum thyroglobulin(Tg)levels increased simultan...A 36-year-old woman with papillary thyroid cancer was diagnosed with a right ovarian mass ultrasono-graphically 2 years earlier.The mass increased in size gradually,and serum thyroglobulin(Tg)levels increased simultaneously to 1002.36 ng/mL;cancer antigen 125 levels remained normal.Preoperative ul-trasonography demonstrated a right ovarian mass(6.3×5.2×3.8 cm)(Figure 1a,Video S1)consisting of homogeneous solid components and multiple follicles(Figure 1b).The mass exhibited high vascularity on color Doppler(Figure 1c).These features highly sug-gested struma ovarii(SO)and were consistent with magnetic resonance imaging findings.Single-port lapa-roscopic right adnexectomy was performed,with ascites seen in the pouch of Douglas(Figure 1d).The right ovary was fully occupied by a tumor(Figure 1e)con-taining grayish-brown gelatinous material(Figure 1f).Pathological examination confirmed SO.The serum Tg level decreased to normal 2 months after laparoscopy,which suggested SO as an extraglandular source of Tg.展开更多
Objective:To review the clinical characteristics of struma ovarii. Methods:Fifty-three cases of struma ovarii treated in this hospital from January 1988 to January 2008 were analyzed retrospectively,and related litera...Objective:To review the clinical characteristics of struma ovarii. Methods:Fifty-three cases of struma ovarii treated in this hospital from January 1988 to January 2008 were analyzed retrospectively,and related literatures were reviewed. Results:Struma ovarii accounted for 1.5%of ovarian teratomas diagnosed at the studied period.The mean age of onset was 39.5 years.All cases were unilateral,occurring equally in either side,with a normal contralateral ovary. Elevated serum levels of CA125(50-2265.7 U/ml) were observed in all 5 patients with ascites.There were no characteristic imaging findings and the confirmed diagnosis was dependent on histology.The management for all patients was surgery.No reoccurrence was found within mean follow-up of 58 months after operation. Conclusion:Struma ovarii is rare and occurs more often in late reproductive age,with a good prognosis.It is difficult to be diagnosed before surgery,and should be distinguished from malignant ovarian tumor.Laparoscopy is the best choice of treatment.展开更多
We report a case of pure struma ovarii tumor diagnosed by cytology during laparoscopic surgery. The patient was a 34-year-old Japanese woman, gravida 1, para 1, who had the left adnexal mass, and was pre-operatively d...We report a case of pure struma ovarii tumor diagnosed by cytology during laparoscopic surgery. The patient was a 34-year-old Japanese woman, gravida 1, para 1, who had the left adnexal mass, and was pre-operatively diagnosed as left ovarian endometriotic cyst or mature cystic teratoma by magnetic resonance imaging findings. She underwent laparoscopy, and the content of the left ovarian cystic tumor was found to be yellow gelatinous material, suggesting mature cystic teratoma. The imprint cytology of the tumor showed benign glandular pattern, suggesting struma ovarii. Histopathological findings led us to the diagnosis of pure struma ovarii with positive reactions for thyroglobulin and thyroid transcription factor-1. No metastases or disseminated lesions were detected. The patient has no recurrent signs 7 months after the operation.展开更多
Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ov...Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ovarii enables the general gynecologic surgeon to continue the planned surgery. However, a diagnosis of malignnancy in a struma ovarii would alter the course of surgery with the involvement of a gynecologic oncology surgeon. We present here that our experience with intraoperative consultation for preoperatively undiagnosed struma ovarii presenting as an adnexal cystic or solid mass at our teaching hospital. Fifty-three cases of struma ovarii, 5.2% of all cystic teratoma of the same period, were diagnosed between January 1991 and March 2011. All intraoperative consultation reports, gross descriptions and final pathology reports were reviewed. The H&E stained slides and in selected cases, immunohistochemistry stained slides, were reviewed. Of the 53 cases of struma ovarii, intraoperative consultation was requested on 48 cases. Frozen section was done on 24 cases and only gross examination was felt appropriate in remaining 24 cases. 83% cases were diagnosed when a frozen section was done. None of the remaining 24 cases were recognized as struma by gross inspection. Our findings reveal that in a large number of cases the diagnosis of struma ovarii remained unrecognized during intraoperative consultation, indicating its often subtle/deceptive gross morphologic appearance. However, the purpose of the intraoperative consultation was served, as appropriate information was provided to the surgeon to guide the surgical management.展开更多
A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She under...A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.展开更多
基金Supported by the Shandong Medical and Health Technology Development Project,No.202102080115。
文摘BACKGROUND Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue,accounting for 1%to 3%of all ovarian teratomas and 0.3%to 1.0%of all ovarian tumors.Of which,struma ovarii with ascites and pleural effusion,called pseudo-Meigs’syndrome and raised cancer antigen-125levels(CA 125)is even rarer.CASE SUMMARY This paper reports the diagnosis and treatment of a patient of struma ovarii with pseudo-Meigs’syndrome,presenting with the clinical features of ovarian carcinoma:Complex pelvic mass,gross ascites,right pleural effusion and markedly elevated serum CA 125 levels.During the operation,a cystic-solid mass about 20cm×10 cm×5 cm in the right adnexa and a solid mass with the size of 3 cm×2cm×0.1 cm in the left ovary were observed.She underwent right adnexectomy and resection of the left ovarian mass and histopathology revealed a mature leftsided ovarian teratoma and struma ovarii of right adnexal mass.During 1-year follow-up,the patient recovered well,tumor markers and other indicators returned to normal.CONCLUSION The diagnosis and treatment process of this case suggests that the clinical symptoms of struma ovarii with pseudo-Meigs’syndrome are lack specificity,which is easily misdiagnosed.Clinicians should improve the understanding of this disease,enhance the awareness of early screening,and improve the level of diagnosis and treatment.
文摘BACKGROUND Struma ovarii is a rare specific ovarian tumor.It is a highly differentiated monodermal teratoma with a malignant transformation rate as low as 5%.Thus,malignant transformation and metastasis are extremely rare.The clinical manifestations of this disease are not typical and are easily misdiagnosed.CASE SUMMARY A 55-year-old female patient had a history of pain in the right hepatic region for approximately 1 year.Computed tomography and magnetic resonance imaging showed a solid cystic mass in the right adnexal region and a solid mass in the right retroperitoneum.The patient underwent surgical resection,and the combined morphological and immunohistochemical results led to the final diagnosis of right struma ovarii with papillary carcinoma and right retroperitoneal lymph node metastasis.CONCLUSION Malignant struma ovarii with distant metastasis is extremely rare,and the clinical manifestations of this disease are nonspecific.Accurate preoperative diagnoses are difficult to obtain,and pathological examination is the gold standard for diagnosing this disease.
文摘Struma ovarii, a rare varity of ovarian neoplasm, belongs to the group of monodermic teratomas mainly composed of thyroid tissue. The preoperative diagnosis is always difficult to identify without histopathological examination. Surgery is the only treatment because malignant alteration is possible and thyroid hyperactivity or hyperthyroidism may occur. Our patient, a post-menopausal women, had unilateral, large, multiloculated ovary mass of 20 cmx 15 cm × 10 cm size without any thyroid hyper activity. The radical excision of the tumor with right ovary was preformed. Histopathological examination confirmed struma ovarii. The post-operative period was uneventful and her thyroid function remained normal.
文摘Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the most common type of malignant struma ovarii, followed by follicular carcinoma. Malignant struma ovarii is commonly seen in women in the fifth decade. The diagnosis is often made post-operatively after histological examination. Histology also helps assess tumor aggressiveness (mitoses, necrosis, poorly differentiated subtype, etc.). Given the rarity of these lesions, no therapeutic consensus or prognostic value had yet been formally established. We report herein, the case of a 76-year-old woman with a cystic tumor of the right ovary and a nodular lesion of the bladder. The clinical symptomatology is nonspecific, associating abdomino-pelvic pain and a right latero-uterine mass on abdominal palpation. After total hysterectomy with bilateral adnexectomy, the diagnosis of papillary carcinoma arising from struma ovarii and extending into the bladder was made. Through this observation, we suggest to discuss the anatomoclinical particularities of this rare pathological entity.
基金National Natural Science Foundation of China,Grant/Award Numbers:U22A2023,62325112,61971447,81301268National High Level Hospital Clinical Research Funding,Grant/Award Numbers:2022-PUMCH-C-009,2022-PUMCH-B-064,2022-PUMCH-D-002Beijing Municipal Natural Science Foundation,Grant/Award Number:JQ18023。
文摘A 36-year-old woman with papillary thyroid cancer was diagnosed with a right ovarian mass ultrasono-graphically 2 years earlier.The mass increased in size gradually,and serum thyroglobulin(Tg)levels increased simultaneously to 1002.36 ng/mL;cancer antigen 125 levels remained normal.Preoperative ul-trasonography demonstrated a right ovarian mass(6.3×5.2×3.8 cm)(Figure 1a,Video S1)consisting of homogeneous solid components and multiple follicles(Figure 1b).The mass exhibited high vascularity on color Doppler(Figure 1c).These features highly sug-gested struma ovarii(SO)and were consistent with magnetic resonance imaging findings.Single-port lapa-roscopic right adnexectomy was performed,with ascites seen in the pouch of Douglas(Figure 1d).The right ovary was fully occupied by a tumor(Figure 1e)con-taining grayish-brown gelatinous material(Figure 1f).Pathological examination confirmed SO.The serum Tg level decreased to normal 2 months after laparoscopy,which suggested SO as an extraglandular source of Tg.
文摘Objective:To review the clinical characteristics of struma ovarii. Methods:Fifty-three cases of struma ovarii treated in this hospital from January 1988 to January 2008 were analyzed retrospectively,and related literatures were reviewed. Results:Struma ovarii accounted for 1.5%of ovarian teratomas diagnosed at the studied period.The mean age of onset was 39.5 years.All cases were unilateral,occurring equally in either side,with a normal contralateral ovary. Elevated serum levels of CA125(50-2265.7 U/ml) were observed in all 5 patients with ascites.There were no characteristic imaging findings and the confirmed diagnosis was dependent on histology.The management for all patients was surgery.No reoccurrence was found within mean follow-up of 58 months after operation. Conclusion:Struma ovarii is rare and occurs more often in late reproductive age,with a good prognosis.It is difficult to be diagnosed before surgery,and should be distinguished from malignant ovarian tumor.Laparoscopy is the best choice of treatment.
文摘We report a case of pure struma ovarii tumor diagnosed by cytology during laparoscopic surgery. The patient was a 34-year-old Japanese woman, gravida 1, para 1, who had the left adnexal mass, and was pre-operatively diagnosed as left ovarian endometriotic cyst or mature cystic teratoma by magnetic resonance imaging findings. She underwent laparoscopy, and the content of the left ovarian cystic tumor was found to be yellow gelatinous material, suggesting mature cystic teratoma. The imprint cytology of the tumor showed benign glandular pattern, suggesting struma ovarii. Histopathological findings led us to the diagnosis of pure struma ovarii with positive reactions for thyroglobulin and thyroid transcription factor-1. No metastases or disseminated lesions were detected. The patient has no recurrent signs 7 months after the operation.
文摘Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ovarii enables the general gynecologic surgeon to continue the planned surgery. However, a diagnosis of malignnancy in a struma ovarii would alter the course of surgery with the involvement of a gynecologic oncology surgeon. We present here that our experience with intraoperative consultation for preoperatively undiagnosed struma ovarii presenting as an adnexal cystic or solid mass at our teaching hospital. Fifty-three cases of struma ovarii, 5.2% of all cystic teratoma of the same period, were diagnosed between January 1991 and March 2011. All intraoperative consultation reports, gross descriptions and final pathology reports were reviewed. The H&E stained slides and in selected cases, immunohistochemistry stained slides, were reviewed. Of the 53 cases of struma ovarii, intraoperative consultation was requested on 48 cases. Frozen section was done on 24 cases and only gross examination was felt appropriate in remaining 24 cases. 83% cases were diagnosed when a frozen section was done. None of the remaining 24 cases were recognized as struma by gross inspection. Our findings reveal that in a large number of cases the diagnosis of struma ovarii remained unrecognized during intraoperative consultation, indicating its often subtle/deceptive gross morphologic appearance. However, the purpose of the intraoperative consultation was served, as appropriate information was provided to the surgeon to guide the surgical management.
文摘A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.
