title: Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature.
abstract: BACKGROUND
  Malignant Struma Ovarii is a rare ovarian neoplasm that is usually asymptomatic and infrequently diagnosed preoperatively. A few case studies have described associated thyrotoxicosis.
  
  
  METHODS
  A 46-year-old female presented for her annual gynecologic exam during which a pelvic mass was appreciated on physical examination. Patient was asymptomatic at presentation. A follow-up ultrasound confirmed the presence of a 16-cm mass in the right adnexa. Patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathology revealed a mature cystic teratoma with features of Struma Ovarii, containing a single 5-mm focus of papillary cancer within the thyroid tissue. Patient subsequently had a thyroid scan that was normal with normal thyroid function. There was no evidence of metastasis.
  
  
  CONCLUSIONS
  Malignant Struma Ovarii is a very rare disease and there are various approaches to treatment based on staging. In our review, we found a higher rate of metastasis than previously reported. Recurrence was seen after an average period of 4 years. We recommend follow-up with surveillance thyroglobulin levels in cases of malignant Struma Ovarii for at least 10 years.
authors.affiliation: Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: Samina
authors.initials: S
authors.lastname: Makani
authors.forename: Wooshin
authors.initials: W
authors.lastname: Kim
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Gaba
mesh_terms: D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D013330:Struma Ovarii / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery