Struma Ovarii In Our Series With Review Of The Literature And Retrospective Analysis

Year 2021, Volume: 22 Issue: 1, 35 - 40, 22.03.2021

Didar Gürsoy , Sibel Hakverdi , Esin Doğan , Tümay Özgür , İlke Evrim Seçinti

Abstract

Objective: To evaluate clinical and pathological features of struma ovarii cases retrospectively. Materials-Metods: The present study included 8 patients reported with pathology of struma ovarii in the medical records. Archive slides were reviewed for diagnostic confirmation, regarding patterns and accompanying thyroid pathologies. Extraovarian dissemination of thyroid tissue, presence of accompanying other ovarian pathologies and that how many cases were composed of pure thyroid tissues were investigated. The clinical features were determined by screening the patient files. Data such tumor size and lateralization were obtained from the pathology reports. Results: The age of the patients ranged between 45-85 years. The most common hospital admission complaint was palpable mass. Five patients had right ovarian struma ovarii. The tumor diamater ranged between 9-15 cm. Tumor was limited by ovary in all the cases. All the struma ovarii cases demonstrated follicular pattern in the microscopic examination. No thyroid-associated malignancy was encountered. Tumor was composed of pure thyroid tissue in 6 cases. We assessed two cases as proliferative struma ovarii. Recurrence was detected during follow-ups in none of the cases. Coclusion: Struma ovarii is the most commonly seen ovarian monodermal teratoma and mostly benign. The presence of malignancy associated with thyroid should be eliminated by a careful histopathological examination in order not to hinder the chance of additional treatment.

Keywords

struma ovari, monodermal teratoma, germ cell tumor

Kliniğimizde Struma Ovarii Olguları: Retrospektif bir İnceleme

Abstract

Amaç: Struma ovarii olgularının klinik ve patolojik özelliklerini retrospektif olarak değerlendirmek

Gereç-Yöntem: Bu çalışmaya tıbbi kayıtlarda struma ovarii tanısı olan 8 hasta dahil edildi. Arşiv preparatları tanı konfirmasyonu, izlenen paternler ve eşlik eden tiroid patolojileri için gözden geçirildi. Tiroid dokusunun over dışı yayılımı, eşlik eden diğer over patolojilerinin varlığı ve kaç tümörün saf tiroid dokusundan oluştuğu araştırıldı. Klinik özellikler hasta dosyaları taranarak belirlendi. Tümör boyutu ve lateralizasyon gibi veriler patoloji raporlarından elde edildi.

Bulgular: Hastaların yaşı 45-85 arasında değişmekteydi. En sık hastaneye başvuru şikayeti ele gelen kitleydi. Beş hastada sağ overde struma ovarii saptadık. Tümör çapları 9-15 cm arasında değişmekteydi. Tüm olgularda tümör overler ile sınırlıydı. Tüm struma ovarii olguları mikroskobik incelemede foliküler patern gösterdi. Altı olguda tümör sadece tiroid dokusundan oluşuyordu. Tiroidle ilişkili malignite ile karşılaşılmadı. İki olguyu proliferatif struma ovarii olarak değerlendirdik. Hiçbir olguda takiplerde nüks saptanmadı.

Sonuç: Struma ovarii en sık görülen overyan monodermal teratomudur ve çoğunlukla benigndir. Tiroid ile ilişkili malignite varlığı, ek tedavi şansını engellememek için dikkatli bir histopatolojik inceleme ile ekarte edilmelidir. 

Keywords

struma ovarii, monodermal teratoma, germ cell tumor

References

• 1. Gonet, A., Ślusarczyk, R., Gąsior-Perczak, D., Kowalik, A., Kopczyński, J., & Kowalska, A. (2020). Papillary Thyroid Cancer in a Struma Ovarii in a 17-Year-Old Nulliparous Patient: A case Report. Diagnostics, 10(1), 45.
• 2. Osakabe, M., Fukagawa, T., Fukagawa, D., Sugimoto, R., Uesugi, N., Ishida, K., ... & Sugai, T. (2017). Case Report Struma ovarii with unique histological features: a case report. Int J Clin Exp Pathol, 10(11), 11230-11233.
• 3. Yasutake, N., Noguchi, H., Ibayashi, Y., Nakamura, H., Tateishi, K., Yuki, K., ... & Fujita, T. (2018). The smallest reported malignant struma ovarii: a case report. Case reports in oncology, 11(3), 693-698.
• 4. Hassan, S. A., Akhtar, A., Falah, N. U., & Sheikh, F. N. (2019). Malignant Thyroid-type Papillary Neoplasm in Struma Ovarii: A Case Report. Cureus, 11(12).
• 5. Wei, S., Baloch, Z. W., & LiVolsi, V. A. (2015). Pathology of struma ovarii: a report of 96 cases. Endocrine pathology, 26(4), 342-348.
• 6. Singh, P., Lath, N., Shekhar, S., Goyal, M., Gothwal, M., Yadav, G., & Khera, P. (2018). Struma ovarii: A report of three cases and literature review. Journal of Mid-life Health, 9(4), 225.
• 7. Kim, D., Cho, H. C., Park, J. W., Lee, W. A., Kim, Y. M., Chung, P. S., ... & Park, C. H. (2009). Struma ovarii and peritoneal strumosis with thyrotoxicosis.
• 8. Frysak, Z., Schovanek, J., Halenka, M., Metelkova, I., Duskova, M., & Karasek, D. (2016). Ovarian gOiter as a rare cause Of hyperthyrOidism. Acta Endocrinologica (Bucharest), 12(3), 335.
• 9. Moayerifar, M., Koohmanaee, S., Moayerifar, M., Nakhochari, A. M., Rad, A. H., & Dalili, S. (2018). Malignant struma ovarii in an 11-year-old girl. Journal of Pediatric Surgery Case Reports, 29, 1-4.
• 10. Yoo, S. C., Chang, K. H., Lyu, M. O., Chang, S. J., Ryu, H. S., & Kim, H. S. (2008). Clinical characteristics of struma ovarii. Journal of gynecologic oncology, 19(2), 135-138.
• 11. Qiao, P. F., Gao, Y., & Niu, G. M. (2015). Struma ovarii accompanied with mature cystic teratoma of the other ovary: A case report and literature review. Oncology letters, 9(5), 2053-2055.
• 12. Kruti P. Maniar and Russell Vang. Germ Cell Tumors of the Ovary. Kurman R (eds). Blaustein’s Pathology of the Female Genital Tract, 7th edition. New York, Springer-Verlag, 2019:1047-1124.
• 13. Wolff, E. F., Hughes, M., Merino, M. J., Reynolds, J. C., Davis, J. L., Cochran, C. S., & Celi, F. S. (2010). Expression of benign and malignant thyroid tissue in ovarian teratomas and the importance of multimodal management as illustrated by a BRAF-positive follicular variant of papillary thyroid cancer. Thyroid, 20(9), 981-987.
• 14. Dujardin, M. I., Sekhri, P., & Turnbull, L. W. (2014). Struma ovarii: role of imaging?. Insights into imaging, 5(1), 41-51.
• 15. Robboy, S. J., Shaco-Levy, R., Peng, R. Y., Snyder, M. J., Donahue, J., Bentley, R. C., ... & Young, R. H. (2009). Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian dissemination. International Journal of Gynecological Pathology, 28(5), 405-422.
• 16. Devaney, K., Snyder, R., Norris, H. J., & Tavassoli, F. A. (1993). Proliferative and histologically malignant struma ovarii: a clinicopathologic study of 54 cases. International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists, 12(4), 333-343.
• 17. DeSimone, C. P., Lele, S. M., & Modesitt, S. C. (2003). Malignant struma ovarii: a case report and analysis of cases reported in the literature with focus on survival and I131 therapy. Gynecologic oncology, 89(3), 543-548.
• 18. Dobi, A., Kim, S. A., Zhang, M., Iames, E., & Lamzabi, I. (2020). Highly differentiated follicular carcinoma of ovary: Use of imprint cytology at intraoperative consultation. Diagnostic Cytopathology, 48(4), 360-363.
• 19. Gild, M. L., Heath, L., Paik, J. Y., Clifton-Bligh, R. J., & Robinson, B. G. (2020). Malignant struma ovarii with a robust response to radioactive iodine. Endocrinology, Diabetes & Metabolism Case Reports, 2020(1).
• 20. Alamdari, M. I., Habibzadeh, A., Pakrouy, H., Chaichi, P., & Sheidaei, S. (2018). An unusual presentation of a papillary thyroid carcinoma in the struma ovarii in a 10 year-old girl: A case report. International journal of surgery case reports, 51, 218-220.