Hyperthyroidism in thyroid carcinoma originating in struma ovarii

Area of Science:

• Gynecology
• Endocrinology
• Oncology

Background:

• Thyroid carcinoma originating in Struma Ovarii (SO) is an exceptionally rare ectopic malignancy.
• It accounts for approximately 0.01% of all ovarian malignancies and is infrequently associated with hyperthyroidism.

Purpose of the Study:

• To report a rare case of papillary thyroid carcinoma arising in Struma Ovarii.
• To emphasize the diagnostic and therapeutic challenges, including the role of thyroid function evaluation and radioiodine therapy (RIT).

Main Methods:

• A 44-year-old patient presented with pelvic pain and was diagnosed with a complex ovarian mass.
• Initial surgery revealed a borderline serous tumor and papillary thyroid carcinoma. Subsequent evaluations included thyroid function tests and TRAb assays.
• The patient underwent total thyroidectomy and radioiodine therapy (RIT).

Main Results:

• Histopathological examination confirmed papillary thyroid carcinoma within the Struma Ovarii, extending to the uterine serosa and right adnexa.
• The patient initially showed hyperthyroidism, which normalized after ovarian surgery, but TRAb remained positive.
• Following total thyroidectomy and RIT, the TRAb test became negative, with no tumor recurrence during 3 years of follow-up.

Conclusions:

• Thyroid function evaluation is crucial in patients diagnosed with Struma Ovarii.
• Radioiodine therapy after total thyroidectomy may be essential for achieving disease remission in high-risk cases of thyroid carcinoma originating in SO.