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Struma ovarii hypothyroidism in children – Struma Ovarii

However, a review by Ezon et al reported that the use of the laparoscopic approach did not negatively impact disease-free or overall survival rates. The medical records of each case was retrospectively reviewed and analysed with respect to management and follow-up.

David Stewart
Thursday, September 21, 2017
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  • All 68 patients in our cohort underwent surgical removal of the cyst or mass. Methods: Twenty-five cases of struma ovarii were reviewed retrospectively from June to April

  • The diagnosis is usually a surprise made after surgery, based on histopathological findings. The overall survival rates at 5, 10, and 20 years were

  • Moreover, in the present study, none of the surgeries performed via laparoscopy required conversion to laparotomy.

  • We examine the challenges involved in the diagnosis and management of this rare entity.

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She had surgery that included removal of her ovaries. Open in new tab Download slide. They aimed to determine whether specific histologic features had predictive value in the clinical outcome of struma ovarii, but no correlation was found [ 15 ]. Savelli et al.

This tumor also shows papillary architecture, nuclear enlargement, hyperchromasia, and nuclear grooves yellow arrow. Uterine Cancer. No evidence of metastasis or peritoneal implants was noted in patients. The neck sonogram revealed multiple bilateral thyroid nodules, varying from 0. Published 23 May Abstract Struma ovarii is a rare ovarian teratoma predominantly composed of thyroid tissue.

All subsequent follow-up and investigations did not suggest any recurrence of the tumour, or metastasis. With struma ovarii hypothyroidism in children to postoperative follow-up, the total number of follow-up sessions after hospital discharge ranged from 0 to The percentage of patients who underwent additional frozen section sampling or staging surgery varied according to their preoperative ultrasonography diagnoses. In the present study, two patients were suspected to have recurrent ovarian cyst on the ipsilateral side of their previous struma ovarii. The majority was of premenopausal status. No recurrence of struma ovarii was histologically diagnosed in any of the 68 patients during their respective duration of follow-up.

INTRODUCTION

A microscopic sample reveals a mature teratoma with thyroid tissue. Based on sgruma data, it is more likely to see a disturbance in serum values of thyroid function test in women with SO. This thyroid tissue can reveal all histological and pathological patterns of normal thyroid epithelium, such as an adenoma or as papillary or follicular carcinoma. Abdelbassir Ramdani.

Materials and Methods. Clinical characteristics of struma ovarii. Pelvic ultrasound revealed a right-solid cystic ovarian mass measuring 2. It occurs mostly in adults between the ages of 30 and 50 years before menopause. Permissions Icon Permissions. Uterine Cancer.

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In the present study, it is evident that laparoscopic surgery resulted in shorter length of hospital stay and lower morbidity as compared to laparotomy. CA levels were elevated in 6 cases. Secondly, struma ovarii hypothyroidism in children struma ovarii is a rare tumour ztruma a relatively nonspecific nature of presentation, which often overlaps and mimics ovarian malignancy, 31011 many surgeons may not have considered it a likely differential intraoperatively. This information can be used as a guide to advise future patients who are scheduled to undergo surgery for struma ovarii or patients who are recovering from similar surgeries. Although postoperative follow-up was planned for almost all the patients in the present study, not every patient underwent postoperative investigations. Conclusion: Struma ovarii is a rare tumor.

Axial CT image of large cystic abdominal mass; a and b Noncontrast-enhanced CT image shows a mass struma ovarii hypothyroidism in children soft tissue components and multiple septations white arrow ; c and d After intravenous bolus of contrast medium soft tissue components showed enhancement within the mass. We present the case of a patient with two independent papillary thyroid carcinomas PTCs in struma ovarii and the thyroid gland that are driven by different RAS mutations. Coexistence of malignant struma ovarii and cervical papillary thyroid carcinoma. This thyroid tissue can reveal all histological and pathological patterns of normal thyroid epithelium, such as an adenoma or as papillary or follicular carcinoma. Lopez, and W. This finding probably represents surveillance bias due to screening neck ultrasound or incidentalomas found during subsequent thyroidectomies. We report our experience in the diagnosis and thyroid function of patients with SO in our hospital and also review the management and treatment option of this tumor.

In particular, does your patient take any medications - OTC drugs or Herbals - sgruma might affect the lab results? It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Search ADS. References R. New issue alert. The simultaneous presence of thyroid carcinoma in the struma ovarii and the thyroid gland is extremely rare.

Publication types

Gynecol Oncol ; 73 : — Select Format Select format. Close mobile search navigation Article Navigation. Kalir, and R.

Moreover, hypothyroivism the present study, none of the surgeries performed via laparoscopy required conversion to laparotomy. These procedures included omental biopsy, omentectomy, appendectomy and peritoneal washing, either in combination or alone. Furthermore, all the patients who experienced postoperative complications including wound inflammation, infection and subsequent incisional ovaii in the present study were those who had undergone surgery via laparotomy. This patient underwent surgery via laparotomy, with no complications or recurrence observed during the 76 months of follow-up. The medical records of each case was retrospectively reviewed and analysed with respect to management and follow-up. However, it is noteworthy that the use of conservative surgery and no adjuvant therapy for the one case of malignant struma ovarii, which was of low-grade malignancy and confined to the ovary, did not show signs of recurrence or metastasis for up to seven years after surgery. As only one patient in the present study had malignant struma ovarii, we were unable to comment on the management of malignant struma ovarii.

This information did not include data for five patients, as these patients were either unavailable or still on follow-up for struma ovarii. As only one patient in the present study had malignant struma ovarii, we were unable to comment on the management of malignant struma ovarii. Therefore, additional procedures would have been carried out before histological diagnosis was obtained based on frozen section sampling. This finding does not concur with the conclusions made by Laberge and Levesque, who suggested that surgery via laparoscopy has a higher risk of recurrence. In view of the diagnoses, it is likely that the indication for these postoperative thyroid function tests was to establish thyroid status, as previous reports have suggested the possibility of hypothyroidism after surgical removal of struma ovarii. The cases of malignant struma ovarii may need adjuvant treatment, but recurrence is uncommon. The medical records of each case was retrospectively reviewed and analysed with respect to management and follow-up.

The left ovary and the rest of the abdomen appeared to be free of disease. Gross macroscopic appearance is that of a large solid tumor with a mixed component mucous and gelatinous content [ 26 ]. Singh, and Z.

In3 In all the cases, the management of struma ovarii was surgical removal. Three of the four patients who suffered wound-related complications after surgery stfuma above 50 years old, and another three of the four had multiple comorbidities, including diabetes mellitus and morbid obesity. Although postoperative follow-up was planned for almost all the patients in the present study, not every patient underwent postoperative investigations. The cases of malignant struma ovarii may need adjuvant treatment, but recurrence is uncommon. In the present study, the mean number of follow-up sessions conducted after surgery was 2.

With regard to postoperative follow-up, the total number of follow-up sessions after hospital discharge ranged from 0 to Patients who had malignancy as the preoperative diagnosis made up the highest percentage of sttuma who underwent additional frozen section sampling or staging surgery, followed by those hypothyroivism dermoid cyst or ovarian teratoma, and finally, those with endometriotic or haemorrhagic cysts. Therefore, this resulted in a large proportion of conservative surgeries being associated with staging procedures. This contrasts with the practice reported by Yoo et al, in which only patients with malignant struma ovarii had regular follow-up for a median of 65 months. In the present study, the mean number of follow-up sessions conducted after surgery was 2. After discussion with the tumour board, it was decided that the patient should not undergo further invasive management. In this single case of malignant struma ovarii, the frozen section of the right ovary obtained intraoperatively suggested a provisional benign diagnosis, and thus, a cystectomy was performed.

In view of the diagnoses, it is likely that the indication for these postoperative thyroid function tests was to establish thyroid status, as previous reports have suggested the possibility of hypothyroidism after surgical removal of struma ovarii. While all chlidren postoperative investigations done within the duration of the follow-up did not reveal any abnormal results that were suggestive of recurrence, one patient who underwent postoperative ultrasonography of the thyroid was found to have four thyroid nodules. The diagnosis was confirmed by pathologic findings. As evidenced in the present study, most of the patients who underwent laparoscopic surgery recovered without incident, had a short duration of hospital stay and did not require extended periods of follow-up or excessive postoperative investigations unless symptomatic. The cysts of these two patients were detected on ultrasonography 2 and 4.

  • The second case involved a year-old woman who underwent a right salpingo-oophorectomy for a right ovarian bulky mass and the histopathological diagnosis was consistent with that of a malignant struma. Savelli et al.

  • In addition, laparoscopic surgery is recommended as strkma surgical approach for the removal of struma ovarii, as it results in a shorter length of hospital stay and a lower incidence of postoperative complications when compared to laparotomy. Access via laparoscopy for the removal of large ovarian cysts is now well established and technically feasible for struma ovarii.

  • Search ADS.

  • In addition, surgical approaches i.

  • There was no follow-up for her thyroid nodules and she did not undergo any treatment for this condition in KKH. CA levels were elevated in 6 cases.

Published 23 May Additionally, both tumors had high levels of expression of the Tg, keratin-7, and NIS gene mRNA as typically seen in well-differentiated thyroid cells and carcinoma. J Clin Invest. Malignant struma ovarii.

Most were also admitted either on the struma ovarii hypothyroidism in children day as their scheduled surgery or one day prior to surgery. As only one patient in the present study had malignant struma ovarii, we were unable to comment on the management of malignant struma ovarii. This included Among these, 24 To the best of our knowledge, no other study has reported results with regard to the length of hospital stay among patients with struma ovarii. As described in previous reports, the key management of struma ovarii is surgical removal.

  • Article Contents Abstract.

  • In all the cases, the management of struma ovarii was surgical removal.

  • Abstract Background.

After treatment, the prognosis of benign strumosis and of malignant SO without metastases is good. The left ovary and the rest of the abdomen appeared to be free of disease. Abstract Background. Oxford University Press is a department of the University of Oxford.

The optimal surgical and postoperative treatment of patients with malignant struma ovarii is still controversial. In the case of benign SO, no complete further treatment other than the unilateral oophorectomy is necessary. Lin, W. Open Next post in Imaging Close.

INTRODUCTION

Three large series of malignant struma ovarii have been published. Cancer Res. Dunzendorfer, A.

Struma ovarii hypothyroidism on preoperative diagnoses from ultrasonography, a further breakdown revealed ovarui procedures in the following patients: 13 of the 20 Conclusion: Struma ovarii is a rare tumor. The presenting clinical, radiologic, and pathologic features of the patients were reviewed. To the best of our knowledge, no other study has reported results with regard to the length of hospital stay among patients with struma ovarii. With regard to the open approach to surgery, the absolute number of such surgeries performed each year revealed no significant trend. In addition, laparoscopic surgery is recommended as the surgical approach for the removal of struma ovarii, as it results in a shorter length of hospital stay and a lower incidence of postoperative complications when compared to laparotomy.

As only one patient in the present study had malignant struma ovarii, we were unable to comment on the management of malignant struma ovarii. The percentage of patients who underwent additional frozen section sampling or staging surgery varied according to their preoperative ultrasonography diagnoses. The most commonly performed investigation was ultrasonography of the pelvis. This patient underwent surgery via laparotomy, with no complications or recurrence observed during the 76 months of follow-up.

However, a review by Ezon et al reported that the use of the laparoscopic approach did not negatively impact disease-free or overall survival rates. The mean number of follow-up sessions was 2. The patient who was admitted a few days after sfruma with complaints of shortness of breath and diarrhoea was treated symptomatically after pulmonary embolism was ruled out, and made full recovery. Secondly, as struma ovarii is a rare tumour with a relatively nonspecific nature of presentation, which often overlaps and mimics ovarian malignancy, 31011 many surgeons may not have considered it a likely differential intraoperatively. While all other postoperative investigations done within the duration of the follow-up did not reveal any abnormal results that were suggestive of recurrence, one patient who underwent postoperative ultrasonography of the thyroid was found to have four thyroid nodules. The majority was of premenopausal status.

Exploratory laparotomy by a Pfannenstiel incision found a multiloculated complex right- cystic ovarian mass. The remaining authors have nothing to disclose. The molecular analysis of the neck lymph node was negative for RAS or other mutations.

Based on preoperative diagnoses from ultrasonography, a further breakdown revealed additional procedures in the following patients: 13 of the 20 All patients with wound-related hypothyroidism children were successfully treated with antibiotics and secondary sutures, and achieved full recovery. There was no follow-up for her thyroid nodules and she did not undergo any treatment for this condition in KKH. In this single case of malignant struma ovarii, the frozen section of the right ovary obtained intraoperatively suggested a provisional benign diagnosis, and thus, a cystectomy was performed. Therefore, the patient was eventually discharged after a total of 76 months of follow-up. Among the 68 patients, 7

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The presenting clinical, radiologic, and pathologic features of the patients were reviewed. In this single case of malignant struma ovarii, the frozen section of the right ovary obtained intraoperatively suggested a provisional benign diagnosis, and thus, a cystectomy was performed. These procedures included omental biopsy, omentectomy, appendectomy and peritoneal washing, either in combination or alone. With regard to postoperative follow-up, the total number of follow-up sessions after hospital discharge ranged from 0 to The single patient with incisional hernia underwent an uneventful hernia repair. In addition, surgical approaches i.

This patient underwent surgery via laparotomy, with no complications or recurrence observed during the 76 months of follow-up. Instead, the patient was scheduled for yearly follow-up, during which ultrasonography was performed and CA values recorded. Details on the use of frozen section for intraoperative diagnosis and the employment of surgical staging techniques for ovarian malignancies e. These findings are similar to those found in a review conducted by Medeiros et al, which examined the advantages and disadvantages of laparotomy and laparoscopy for benign ovarian tumours. The mean number of follow-up sessions was 2. Firstly, many cases of struma ovarii in the present study were preoperatively diagnosed as possible malignancies based on the findings of the investigations.

1. Patient and Methods

Subsequently, a right ovarian cystectomy was performed Fig. The protocol was approved by the local institutional review board. Struma ovarii SO is a variant of dermoid tumors which completely or mainly composed of thyroid tissues. With the use of immunohistochemistry, the cyst lining was shown to express thyroglobulin. She recovered well after surgery and was discharged on day 3.

Very little is known about the molecular mechanisms of these tumors and whether the thyroid and ovarian tissues harbor the same abnormalities and thus have similar mechanisms of development and progression. Three large series of malignant struma ovarii have been published. Singh, and Z. Disclosure Summary: Y. Related articles.

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View at: Google Scholar. Laboratory data on admission of women revealed no abnormality value in blood cell count, serum creatinine level, and erythrocyte sedimentation rate ESR. Struma ovarii in bilateral ovarian teratoma—case report and literature review. No mutations were found in the adjacent normal ovarian tissue. Open in new tab Download slide. A definitive diagnosis is confirmed postoperatively based on histopathological findings of the resected ovary. There is papillary architecture with fibrovascular cores white arrow.

The presenting clinical, radiologic, and pathologic features of the patients were reviewed. One struma ovarii hypothyroidism in children had no data regarding follow-up. The treatment voarii benign struma ovarii is surgical resection only. Instead, the patient was scheduled for yearly follow-up, during which ultrasonography was performed and CA values recorded. A total of 39 Details on the use of frozen section for intraoperative diagnosis and the employment of surgical staging techniques for ovarian malignancies e. In the present study, most of the patients stayed in the hospital for a maximum of four days, after which they were discharged home well without incident.

Yoo et al. Coexistence of malignant struma ovarii and cervical papillary thyroid carcinoma. They found that only 13 cases were malignant using thyroid gland criteria. All the authors testified to the care of the patient and the writing of the manuscript.

With regard to postoperative follow-up, the total number of follow-up sessions after hospital discharge ranged from 0 to Hypothjroidism, the percentage of open approach surgeries dropped to To the best of our knowledge, no other study has reported results with regard to the length of hospital stay among patients with struma ovarii. Objective: To evaluate the clinical characteristics of struma ovarii. Firstly, many cases of struma ovarii in the present study were preoperatively diagnosed as possible malignancies based on the findings of the investigations.

The coexistence of papillary thyroid carcinoma PTC not only in the struma ovarii but also in the thyroid struma ovarii hypothyroidism in children extremely unusual, with few reports in the literature [ 23 ]. The serum TSH concentration was 1. InDevaney et al. Search Menu. Figure 4. Axial CT image of large cystic abdominal mass; a and b Noncontrast-enhanced CT image shows a mass with soft tissue components and multiple septations white arrow ; c and d After intravenous bolus of contrast medium soft tissue components showed enhancement within the mass. Hematoxylin and eosin staining of ovary and thyroid tumors.

A year before, the CT scan had demonstrated only stable enlarged pelvic lymph hypotyroidism. Open in new tab Download slide. Please login or register first to view this content. Shen, X. The neck sonogram revealed multiple bilateral thyroid nodules, varying from 0. Ultrasound examination of the ovaries, as well as CT and MR studies, can help identify multilocular cystic ovarian masses with a solid component, but these do not allow differentiation of struma ovarii from other ovarian masses.

Journal of Cancer Research

Among the patients who underwent ultrasonography of the pelvis after surgery, the images of 15 hypotthyroidism As only one patient in the present study had malignant struma ovarii, we were unable to comment on the management of malignant struma ovarii. This finding supports previous studies that suggest that struma ovarii is of low malignancy and low metastatic potential. As evidenced in the present study, most of the patients who underwent laparoscopic surgery recovered without incident, had a short duration of hospital stay and did not require extended periods of follow-up or excessive postoperative investigations unless symptomatic. After discussion with the tumour board, it was decided that the patient should not undergo further invasive management.

All patients provided an informed written consent; the study was approved by Ethics Committee of Tajrish Hospital. Zhu, and J. Select Format Select format. Surgical specimen of the resected right adnexa mass. Malik, and E.

The patient showed no signs or symptoms of hyperthyroidism, and the hormonal thyroid function test was normal. Struma ovarii in bilateral ovarian teratoma—case report and literature review. Testa, D. The nodules were either mixed cystic-solid or hypoechoic, without any additional suspicious features. Department of Surgical Oncology. Additional issues of Clinical Importance It is important to consider struma ovarii in a woman with a proposed laparotomy because a thyroid crisis can be precipitated following the surgical procedure. Open Next post in Imaging Close.

Many authors provide followup from 4 months to 3 years for patients with benign, nonfunctional disease [ 4 ]. Advance article alerts. J Clin Invest.

Conservative surgery is reserved struma ovarii hypothyroidism in children younger patients seeking to preserve fertility if the disease is confined to the ovary, followed by definitive surgery after completion of childbearing [ 79 ]. Gynecol Obstet Fertil ; 44 : — 8. Salman, M. Reynolds, W. The authors suggest that pelvic surgery alone may be sufficient initial therapy and that prophylactic total thyroidectomy with radioactive iodine should be reserved for patients with gross extraovarian spread or distant metastasis.

Citing articles via Google Children. Hypothyroidims alerts Article activity alert. The different imaging modalities including ultrasound, CT and magnetic resonance imaging are nonspecific and often suspect of malignancy. The patient had dosimetry and received Malignant struma ovarii: two case reports and a review of the literature. We believe that factors such as age, desire to preserve fertility of the patient, size of the ovarian tumor, presence of thyroid nodules, and need for radioiodine therapy should be taken into consideration for each patient.

In the present study, most hypthyroidism the patients stayed in the hospital for a maximum of four days, after which they were discharged home well without incident. Histology revealed benign struma ovarii in all The remaining one-third of the patients, including one patient with malignant struma ovarii, had more than one year of follow-up. Among the patients who underwent ultrasonography of the pelvis after surgery, the images of 15 Abstract Objective: To evaluate the clinical characteristics of struma ovarii.

There was no follow-up for her thyroid nodules and she did not undergo any treatment for this condition in KKH. Therefore, the patient was eventually discharged hypothyrodiism a total of struma ovarii hypothyroidism in children months of follow-up. These findings are similar to those found in a review conducted by Medeiros et al, which examined the advantages and disadvantages of laparotomy and laparoscopy for benign ovarian tumours. The length of inpatient stay ranged from 0 to 37 days, with a mean length of stay of 4. In the present study, only 1 1. One patient had no data regarding follow-up.

  • The diagnosis relies on histopathological examination and is infrequently made on routine investigations.

  • The cases of malignant struma ovarii may need adjuvant treatment, but recurrence is uncommon.

  • To test this hypothesis, we performed molecular analysis of normal ovarian tissue, but no mutations were found in ovarian stromal cells.

  • Open in new tab Download slide. More on this topic Ovarian endosalpingiosis mimicking hydrosalpinges.

A total of 39 The cysts of hypthyroidism two patients were detected on ultrasonography 2 and 4. Based on preoperative diagnoses from ultrasonography, a further breakdown revealed additional procedures in the following patients: 13 of the 20 Furthermore, all the patients who experienced postoperative complications including wound inflammation, infection and subsequent incisional hernia in the present study were those who had undergone surgery via laparotomy.

We report two cases of struma ovarii: one benign and the other malignant. What Lab Results are Absolutely Confirmatory? Download all slides. In particular, does your patient take any medications - OTC drugs or Herbals - that might affect the lab results?

Most were chilldren admitted either on the same day as their scheduled surgery or one day prior to surgery. Therefore, additional procedures would have been carried out before histological diagnosis was obtained based on frozen section sampling. This patient underwent surgery via laparotomy, with no complications or recurrence observed during the 76 months of follow-up. None of the patients who stated a desire for future fertility underwent radical surgery.

This information can be used as a guide to advise future patients who are scheduled to undergo surgery for struma ovarii or patients who are recovering from similar surgeries. Three of the four patients who suffered wound-related complications after surgery were above 50 years old, and another three of the four had multiple comorbidities, including diabetes mellitus and morbid obesity. In the present study, just over half of the study cohort underwent frozen section sampling or staging procedures as part of their surgery. Abstract Objective: To evaluate the clinical characteristics of struma ovarii.

In addition, laparoscopic surgery is recommended as the surgical approach for the removal of struma ovarii, as it results in a shorter length of hospital stay and a lower incidence of postoperative complications when compared to laparotomy. Even though the number of surgeries performed via open access exceeded the number of surgeries via laparoscopy, our results showed a clear trend of increasing popularity of laparoscopic surgery. In all the cases, the management of struma ovarii was surgical removal. The treatment of benign struma ovarii is surgical resection only.

Access via laparoscopy for the removal of large ovarian cysts is now well established and technically feasible for hypothyroidism children ovarii. Sixteen patients had clinical symptoms such as low abdominal vhildren, palpable abdominal mass and vaginal bleeding. Objective: To evaluate the clinical characteristics of struma ovarii. One patient had no data regarding follow-up. Data on recurrence of benign struma ovarii is scarce, while that on malignant struma ovarii is relatively low. However, both of these patients remained clinically asymptomatic. However, a review by Ezon et al reported that the use of the laparoscopic approach did not negatively impact disease-free or overall survival rates.

Histology revealed benign struma ovarii in all Furthermore, all the patients who experienced postoperative hypothjroidism including wound elderly, infection and subsequent incisional hernia in the present study were those who had undergone surgery via laparotomy. With regard to postoperative follow-up, the total number of follow-up sessions after hospital discharge ranged from 0 to

Thyroid function tests were struma ovarii hypothyroidism in children for eight patients, one of whom was the patient diagnosed with malignant struma ovarii. The cases of malignant struma ovarii may need adjuvant treatment, but recurrence is uncommon. In the present study, two patients were suspected to have recurrent ovarian cyst on the ipsilateral side of their previous struma ovarii. Therefore, additional procedures would have been carried out before histological diagnosis was obtained based on frozen section sampling. In addition, surgical approaches i.

However, such information was unavailable at the time children data collection and analysis. The single ovario with incisional hernia underwent an uneventful hernia repair. All 68 patients in our cohort underwent surgical removal of the cyst or mass. Methods: Twenty-five cases of struma ovarii were reviewed retrospectively from June to April Interestingly, no surgery was performed via laparoscopy in — and —

  • Are there any factors that might affect the lab results? Boettlin who was first to describe SO in as the presence of thyroid follicular tissue in ovaries, and after that Gottschalk published further reports [ 6 ].

  • The medical records of each case was retrospectively reviewed and analysed with respect to management and follow-up. In the present study, two patients were suspected to have recurrent ovarian cyst on the ipsilateral side of their previous struma ovarii.

  • A comprehensive survey of Ras mutations in cancer.

  • All 68 patients in our cohort underwent surgical removal of the cyst or mass.

E-mail: kenneth. We present the severe hypothyroidism in elderly of a patient with two independent PTCs in struma ovarii and the thyroid gland that are driven by different RAS mutations. Malignant struma ovarii: report of two cases and selected review of the literature. More recently, Goffredo et al. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Advance article alerts.

Show More. Boettlin who was first to describe SO in as the presence of thyroid struma ovarii hypothyroidism in children tissue in ovaries, and after that Gottschalk published further reports [ 6 ]. Ultrasound examination of the ovaries, as well as CT and MR studies, can help identify multilocular cystic ovarian masses with a solid component, but these do not allow differentiation of struma ovarii from other ovarian masses. SO may be diagnosed at any age, even in children, but it occurred mostly in reproductive years of patients [ 4 ]. Xanthogranulomatous appendicitis with elevated tumor marker misdiagnosed as cecal cancer: a case report. View Metrics.

Download all slides. The molecular analysis of the neck lymph node was negative for RAS or other mutations. Zilbert, L. Email alerts Article activity alert.

A Features of children papillary carcinoma on ovarian teratoma with multilocular mucinous ocarii red circle ; B crowded overlapping nuclei with elongated powdery chromatin. Pelvic ultrasound revealed a right-solid cystic ovarian mass measuring 2. Xia, Y. The simultaneous presence of thyroid carcinoma in the struma ovarii and the thyroid gland is extremely rare. J Gynecol Oncol ; 19 : — 8. A struma carcinoid, although very rare, should not be missed on histologic examination. Common radiological features include a large complex multilobulated mass with thickened partitions and multiple cysts with solid components.

Among the patients who underwent ultrasonography of the pelvis after surgery, the images of 15 Thyroid function children were ordered for eight patients, one of whom was the patient diagnosed with malignant struma ovarii. Secondly, as struma ovarii is a rare tumour with a relatively nonspecific nature of presentation, which often overlaps and mimics ovarian malignancy, 31011 many surgeons may not have considered it a likely differential intraoperatively. As described in previous reports, the key management of struma ovarii is surgical removal.

We also analysed data on admission, length of hospital stay for surgery, complications of surgery, hcildren well as length and number of sessions of postoperative follow-up and investigations. None of the patients who stated a desire for future fertility underwent radical surgery. However, it should be noted that multiple preoperative diagnoses may be offered within a single ultrasonography report, and this may dilute the strength of direct correlation between the preoperative diagnosis and the actual surgery performed.

This contrasts with the practice reported by Yoo et al, in struma ovarii hypothyroidism in children only patients with malignant struma ovarii had regular follow-up for a median of 65 months. In view of the diagnoses, it is likely that the indication for these postoperative thyroid function tests was to establish thyroid status, as previous reports have suggested the possibility of hypothyroidism after surgical removal of struma ovarii. Although postoperative follow-up was planned for almost all the patients in the present study, not every patient underwent postoperative investigations. Keywords: Dermoid tumor; Malignancy; Struma ovarii.

Trend of laparotomy vs. None of the patients who stated a desire for future fertility underwent radical surgery. This information did not include data for five patients, as these patients were either unavailable or still on follow-up for struma ovarii. As neither patient underwent surgical removal of the cyst as they were not keen to undergo surgerywe were unable to obtain histological diagnoses of the cysts to confirm or exclude recurrence. Results: The mean age of the patients in this study was However, the percentage of open approach surgeries dropped to The most commonly performed investigation was ultrasonography of the pelvis.

The mean number of follow-up sessions was 2. However, when the percentage of open approach sgruma was compared with that of laparoscopic surgeries, we found that the former accounted struma ovarii hypothyroidism In addition, laparoscopic surgery is recommended as the surgical approach for the removal of struma ovarii, as it results in a shorter length of hospital stay and a lower incidence of postoperative complications when compared to laparotomy. Therefore, this resulted in a large proportion of conservative surgeries being associated with staging procedures. The postoperative thyroid function tests of the other six patients were normal, and they remained clinically asymptomatic for both hyper- and hypothyroidism.

Register now at no charge to access unlimited clinical strumma, full-length features, case studies, conference coverage, and more. Gynecol Obstet Fertil ; 44 : — 8. Arch Pathol Lab Med. Because of the paucity of SO, there is no clarity regarding the proper management of these patients [ 4 ]. Struma ovarii is bottom right field blue arrow.

She was asymptomatic and did not receive any chemotherapy or radiotherapy. Sign In. Malik, and E. Struma ovarii is a rare ovarian teratoma predominantly composed of thyroid tissue.

Close mobile search navigation Article Navigation. Between andfifteen patients were included in this study. Conservative surgery cystectomy or oophorectomy is recommended [ 8 ]. Department of Radiology. Between and15 consecutive females with SOs who were presented to our hospital were fully assessed.

  • The diagnostic criterion of SO is based on histological features of the resected ovary. Cakal, and T.

  • However, the indication for thyroid function test before surgery was not explicitly stated in the medical records, and the patient was asymptomatic and had no past medical history. About two-thirds of the patients did not undergo any form of postoperative investigation.

  • Considering the potential to metastasize over the years even when apparently restricted to the ovary, we advise prophylactic thyroidectomy and radioiodine as part of the management of malignant struma ovarii. Lyu, S.

  • Oxford University Press is a department of the University of Oxford. This approach may contribute to the eventual finding of occult thyroid carcinomas, but it allows an adequate follow-up with serum Tg levels and imaging studies of the neck sonogram and pelvis CT or MRI.

As discussed, elevation of CA is not diagnostic of a malignant ovarian tumor and is known to occur in benign struma ovarii. Login Register. Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors. J Gynecol Oncol ; 19 : — 8. Savelli et al. Struma ovarii is a rare ovarian teratoma predominantly composed of thyroid tissue. All patients provided an informed written consent; the study was approved by Ethics Committee of Tajrish Hospital.

  • It is important to consider struma ovarii in a woman with a proposed laparotomy because a thyroid crisis can be precipitated following the surgical procedure. The serum TSH concentration was 1.

  • However, histopathology subsequently revealed microscopic vascular invasion and the presence of irregular tongue-like projections into the surrounding tissue, which led to the histological diagnosis of malignant struma ovarii.

  • The diagnosis of a benign struma was made after histopathological study.

  • Materials and Methods Between and15 consecutive females with SOs who were presented to our hospital were fully assessed.

  • Many authors agree that due to the many similarities with thyroid cancer, it should be considered and managed as thyroid cancer ovarian surgery, thyroidectomy and I radio-ablation rather than ovarian cancer ovarian surgery, radiotherapy and chemotherapy [ 127 ].

  • With regard to the open approach to surgery, the absolute number of such surgeries performed each year revealed no significant trend.

Figure 4. Clinical manifestations include hyperandrogenism or hyperestrogenism, as well as hyperthyroidism. Struma ovarii SO is a variant of dermoid tumors hypothyroidim children ovary in which thyroid tissue components is the major constituent [ 1 ]. Arch Pathol Lab Med. This tumor generally presents with nonspecific symptoms that are analogous to those of other ovarian neoplasms. The protocol was approved by the local institutional review board.

Ozkaya, E. She recovered well after surgery and was discharged on day 3. A year before, the CT scan had demonstrated only stable enlarged chileren lymph nodes. Histologic examination of tissues is a must to evaluate the extent of thyroid tissue severe hypothyroidism in elderly the teratoma, as well as for diagnostic purposes and differentiation from other types of ovarian tumors. Other authors analyzed 86 cases of malignant struma ovarii, including 26 in which the tumor had spread onto the surface of the ovary or beyond. Conservative surgery is reserved for younger patients seeking to preserve fertility if the disease is confined to the ovary, followed by definitive surgery after completion of childbearing [ 79 ]. Struma ovarii in bilateral ovarian teratoma—case report and literature review.

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