Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T17:23:16.591Z Has data issue: false hasContentIssue false

Struma ovarii and the thyroid surgeon

Published online by Cambridge University Press:  25 May 2012

S Gunasekaran*
Affiliation:
Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
E Kopecka
Affiliation:
Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
K H Maung
Affiliation:
Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
R J England
Affiliation:
Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
*
Address for correspondence: Mr Sinnappa Gunasekaran, 9 Woodlea Garth, Leeds LS6 4SG, UK E-mail: [email protected]

Abstract

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Mistry, D, Atkin, S, Atkinson, H, Gunasekaran, S, Sylvester, D, Rigby, AS et al. Predicting thyroxine requirements following total thyroidectomy. Clin Endocrinol (Oxf) 2011;74:384–7CrossRefGoogle ScholarPubMed
2 MacLeod, DH. Struma ovarii (thyro-dermoid). A note on the teratomatous origin. Proc R Soc Med 1932;25:1386–91Google ScholarPubMed
3 Willemse, PH, Oosterhuis, JW, Aalders, JG. Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131 I administration. Cancer 1987;60:178–823.0.CO;2-Q>CrossRefGoogle Scholar
4 Wirtz, ED, Bothwell, N, Klem, C. Role of the otolaryngologist in the treatment of struma ovarii. Laryngoscope 2009;120:259–60CrossRefGoogle Scholar
5 Devaney, K, Snyder, R, Norris, H, Tavassoli, FA. Proliferative and histologically malignant struma ovarii: a clinicopathologic study of 54 cases. Int J Gynecol Pathol 1993;12:333–43CrossRefGoogle ScholarPubMed
6 Makani, S, Kim, W, Gaba, A. Struma ovarii with a focus of papillary thyroid cancer; a case report and review of the literature. Gynecol Oncol 2004;94:835–49CrossRefGoogle ScholarPubMed
7 Robboy, SJ, Shaco-Levy, R, Peng, RY, Snyder, MJ, Donahue, J, Bentley, RC et al. Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol 2009;28:405–22CrossRefGoogle ScholarPubMed