title: Malignant struma ovarii: good response after thyroidectomy and I ablation therapy.
abstract: BACKGROUND
  Malignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature.
  
  
  METHODS
  We present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and (131)I ablation therapy, two patients as first line management, one following the occurrence of metastatic disease.
  
  
  CONCLUSIONS
  Histological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine ((131)I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine ((123)I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.
authors: Department of Obstetrics and Gynecology, sector of gynecologic oncology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors: Erica W M
authors: EW
authors: Janszen
authors: Helena C
authors: HC
authors: van Doorn
authors: Patricia C
authors: PC
authors: Ewing
authors: Ronald R
authors: RR
authors: de Krijger
authors: Johannes H W
authors: JH
authors: de Wilt
authors: Boen L R
authors: BL
authors: Kam
authors: Wouter W
authors: WW
authors: de Herder