Journal article
Concurrent Intrathyroidal Thyroid Cancer and Thyroid Cancer in Struma Ovarii: A Case Report and Literature Review
Journal of the Endocrine Society, Vol.1(5), pp.396-400
05/01/2017
DOI: 10.1210/js.2017-00052
PMCID: PMC5686688
PMID: 29264493
Abstract
Context: The presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries is rare, and usually incidentally found on surgical pathology specimens. We present a case of simultaneous intrathyroidal thyroid cancer and thyroid cancer within a struma ovarii, presenting specific diagnostic challenges.
Case Description: A 55-year-old woman had an intrathyroidal, encapsulated 1.2-cm papillary thyroid carcinoma, follicular variant, which was resected. Laboratory studies showed an elevated thyroglobulin level of 35 ng/mL while on suppressive levothyroxine therapy. During preparation for radioactive iodine ablation, thyroglobulin increased dramatically to 3490 ng/mL. A pretreatment whole-body scan showed residual tracer uptake in the thyroid bed and increased radiotracer uptake in the pelvis that raised concern for a pelvic metastasis, given the marked thyroglobulin elevation. After ablation, the posttreatment scan showed intense focal uptake in the pelvis. Single-photon emission computed tomography-computed tomography confirmed that the tracer uptake corresponded to a right adnexal mass. The patient underwent a laparoscopic bilateral salpingo-oophorecotomy with pelvic washings. The final pathology of the right ovary showed papillary thyroid carcinoma arising in amature cystic teratoma. In addition, there was abundant normal thyroid tissue with colloid surrounding the carcinoma, indicating a source for the dramatic rise in thyroglobulin levels and suggesting that the ovarian papillary thyroid cancer arose within the teratoma and was not metastatic disease. Thyroglobulin measurements have been undetectable for 5 years since surgery and radioiodine treatment.
Conclusions: Concurrent intrathyroidal thyroid cancer and differentiated thyroid cancer in struma ovarii are very rare, but can often be distinguished on clinical grounds. Copyright (c) 2017 Endocrine Society. This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND).
Details
- Title: Subtitle
- Concurrent Intrathyroidal Thyroid Cancer and Thyroid Cancer in Struma Ovarii: A Case Report and Literature Review
- Creators
- Roeland J. W. Middelbeek - Beth Israel Deaconess Medical CenterBrian T. O'Neill - Univ Iowa, Fraternal Order Eagles Diabet Res Ctr, Carver Coll Med, Div Endocrinol & Metab, Iowa City, IA 52242 USAMichiya Nishino - Beth Israel Deaconess Medical CenterJohanna A. Pallotta - Beth Israel Deaconess Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of the Endocrine Society, Vol.1(5), pp.396-400
- Publisher
- Endocrine Soc
- DOI
- 10.1210/js.2017-00052
- PMID
- 29264493
- PMCID
- PMC5686688
- ISSN
- 2472-1972
- eISSN
- 2472-1972
- Number of pages
- 5
- Grant note
- T32-DK-07260-038 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 05/01/2017
- Academic Unit
- Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984359775202771
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