Struma ovarii and the thyroid surgeon.
Summary of "Struma ovarii and the thyroid surgeon."
Introduction:Struma ovarii is a rare, monodermal, ovarian teratoma. The common presentation is abdominal, with pelvic mass and pain, traditionally managed by gynaecologists. The malignant form is extremely rare and consists of differentiated thyroid cancer. It is rare for struma ovarii to present with features of hyperthyroidism. We present two unusual cases of struma ovarii and discuss the role of the thyroid surgeon in their management.Methods and results:The first case involved a 40-year-old woman with a two-month history of swelling in the lower abdomen. Investigations revealed a mass arising from the left ovary. Surgery revealed a follicular carcinoma arising in a struma ovarii. She underwent a total thyroidectomy prior to radio-iodine therapy. The second case involved a 60-year-old woman who underwent thyroidectomy for thyrotoxicosis. Three months post-operatively, she remained thyrotoxic despite stopping thyroxine. A whole body radio-iodine scan revealed high uptake in the left ovary. Histological analysis of the resected ovary showed benign struma ovarii.Conclusion:These two cases highlight the diagnostic and therapeutic role of thyroid surgeons in the management of benign and malignant forms of struma ovarii.
Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK.
This article was published in the following journal.
Name: The Journal of laryngology and otology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22624934
- DOI: http://dx.doi.org/10.1017/S0022215112000904
Medical and Biotech [MESH] Definitions
A rare teratoid tumor of the ovary composed almost entirely of thyroid tissue, with large follicles containing abundant colloid. Occasionally there are symptoms of hyperthyroidism. 5-10% of struma ovarii become malignant, the only absolute criterion for which is the presence of metastasis. (Dorland, 27th ed; Segen, Dictionary of Modern Medicine, 1992)
Autoantibodies that bind to the thyroid-stimulating hormone (TSH) receptor (RECEPTORS, THYROTROPIN) on thyroid epithelial cells. The autoantibodies mimic TSH causing an unregulated production of thyroid hormones characteristic of GRAVES DISEASE.
A condition characterized by the presence of rudimentary THYROID tissue at the base of the TONGUE. It is due to failed embryonic development and migration of thyroid tissue to its normal location. The lingual thyroid usually cannot maintain adequate hormone production thereby resulting in HYPOTHYROIDISM.
Hypersecretion of THYROID HORMONES from the THYROID GLAND. Elevated levels of thyroid hormones increase BASAL METABOLIC RATE.
Defective development of the THYROID GLAND. This concept includes thyroid agenesis (aplasia), hypoplasia, or an ectopic gland. Clinical signs usually are those of CONGENITAL HYPOTHYROIDISM.
Struma ovarii, as a monodermal variant of ovarian teratoma, constitutes about less than 3% of ovarian teratomas. It is difficult to be macroscopically recognized. Multiple appearances under microscope...
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