Malignant struma ovarii: good response after thyroidectomy and I ablation therapy

Area of Science:

• Gynecologic Oncology
• Endocrinology
• Nuclear Medicine

Background:

• Malignant struma ovarii is a rare ovarian germ cell tumor.
• Treatment protocols for this rare condition lack standardization in existing literature.

Observation:

• Presents three cases of malignant struma ovarii.
• All patients underwent primary surgery, followed by thyroidectomy and radioactive iodine ((131)I) ablation therapy.
• Two patients received this as initial treatment; one received it after metastasis developed.

Findings:

• Histological diagnosis mirrors well-differentiated thyroid carcinoma (WDTC).
• Recommended treatment involves surgical excision of the ovarian tumor, followed by total thyroidectomy.
• This approach facilitates radioiodine ((131)I) ablation for potential micrometastases and allows thyroglobulin monitoring.

Implications:

• Total thyroidectomy aids in excluding primary thyroid carcinoma and enables effective (131)I ablation therapy.
• Thyroglobulin levels serve as a crucial tumor marker for post-treatment surveillance.
• Nuclear medicine imaging with radioiodine ((123)I) can detect metastatic disease, underscoring the need for a multidisciplinary approach.