Presentation and treatment of two cases of malignant struma ovarii
Abstract Background Malignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly estab...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-024-03002-5 |
| _version_ | 1827326400195985408 |
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| author | Rawan A. Obeidat Sakhr Alshwayyat Tala Abdulsalam Alshwayyat Anwar Rjoop Qosay Mahmoud Sharqiah |
| author_facet | Rawan A. Obeidat Sakhr Alshwayyat Tala Abdulsalam Alshwayyat Anwar Rjoop Qosay Mahmoud Sharqiah |
| author_sort | Rawan A. Obeidat |
| collection | DOAJ |
| description | Abstract Background Malignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly established due to the paucity of MSO cases. Case 1 A 44-year-old multiparous female presented with an irregular period. Ultrasound showed a left ovarian lesion mostly a dermoid cyst, however, CT showed a 3.8 × 2.7 × 4 cm complex cystic lesion with thick septation and enhancing soft tissue component. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed a follicular variant of papillary thyroid carcinoma arising in a mature cystic teratoma. Peritoneal cytology was positive for malignancy. A thyroid function test was normal before surgery. Total thyroidectomy was performed followed by radioactive (RAI) iodine therapy. Later, a total laparoscopic hysterectomy and right salpingo-oophorectomy were performed. There is no evidence of recurrent disease during the 26-months follow-up. Case 2 A 46-year-old single female presented with left lower abdominal pain that had persisted for 2 months. Imaging revealed an 8 × 9 × 9.5 cm left ovarian mass. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed mature cystic teratoma with small papillary thyroid cancer. CT showed no evidence of metastatic disease. Later, the patient had a total thyroidectomy followed by radioactive (RAI) iodine therapy. She was started on thyroxine and later had total abdominal hysterectomy and right salpingo-oophorectomy. Conclusion MSO is a very rare tumour. Preoperative diagnosis is very difficult because of the nonspecific symptoms and the lack of specific features in imaging studies. Also, there is no consensus on the optimal treatment of women with MSO. Our two cases add to the limited number of MSO cases. |
| first_indexed | 2024-03-07T14:43:56Z |
| format | Article |
| id | doaj.art-b0a1004994ae401b87d58d2bad255f26 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-03-07T14:43:56Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-b0a1004994ae401b87d58d2bad255f262024-03-05T20:08:21ZengBMCBMC Women's Health1472-68742024-03-012411610.1186/s12905-024-03002-5Presentation and treatment of two cases of malignant struma ovariiRawan A. Obeidat0Sakhr Alshwayyat1Tala Abdulsalam Alshwayyat2Anwar Rjoop3Qosay Mahmoud Sharqiah4Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and TechnologyFaculty of Medicine, Jordan University of Science and TechnologyFaculty of Medicine, Jordan University of Science and TechnologyDepartment of Pathology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Pathology, Faculty of Medicine, Jordan University of Science and TechnologyAbstract Background Malignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly established due to the paucity of MSO cases. Case 1 A 44-year-old multiparous female presented with an irregular period. Ultrasound showed a left ovarian lesion mostly a dermoid cyst, however, CT showed a 3.8 × 2.7 × 4 cm complex cystic lesion with thick septation and enhancing soft tissue component. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed a follicular variant of papillary thyroid carcinoma arising in a mature cystic teratoma. Peritoneal cytology was positive for malignancy. A thyroid function test was normal before surgery. Total thyroidectomy was performed followed by radioactive (RAI) iodine therapy. Later, a total laparoscopic hysterectomy and right salpingo-oophorectomy were performed. There is no evidence of recurrent disease during the 26-months follow-up. Case 2 A 46-year-old single female presented with left lower abdominal pain that had persisted for 2 months. Imaging revealed an 8 × 9 × 9.5 cm left ovarian mass. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed mature cystic teratoma with small papillary thyroid cancer. CT showed no evidence of metastatic disease. Later, the patient had a total thyroidectomy followed by radioactive (RAI) iodine therapy. She was started on thyroxine and later had total abdominal hysterectomy and right salpingo-oophorectomy. Conclusion MSO is a very rare tumour. Preoperative diagnosis is very difficult because of the nonspecific symptoms and the lack of specific features in imaging studies. Also, there is no consensus on the optimal treatment of women with MSO. Our two cases add to the limited number of MSO cases.https://doi.org/10.1186/s12905-024-03002-5Malignant struma ovariiMature cystic teratomasRadioactive iodineSalpingo-oophorectomyHysterectomy |
| spellingShingle | Rawan A. Obeidat Sakhr Alshwayyat Tala Abdulsalam Alshwayyat Anwar Rjoop Qosay Mahmoud Sharqiah Presentation and treatment of two cases of malignant struma ovarii BMC Women's Health Malignant struma ovarii Mature cystic teratomas Radioactive iodine Salpingo-oophorectomy Hysterectomy |
| title | Presentation and treatment of two cases of malignant struma ovarii |
| title_full | Presentation and treatment of two cases of malignant struma ovarii |
| title_fullStr | Presentation and treatment of two cases of malignant struma ovarii |
| title_full_unstemmed | Presentation and treatment of two cases of malignant struma ovarii |
| title_short | Presentation and treatment of two cases of malignant struma ovarii |
| title_sort | presentation and treatment of two cases of malignant struma ovarii |
| topic | Malignant struma ovarii Mature cystic teratomas Radioactive iodine Salpingo-oophorectomy Hysterectomy |
| url | https://doi.org/10.1186/s12905-024-03002-5 |
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