A case report of thyroid carcinoma confined to ovary and concurrently occult in the thyroid: is conservative treatment always advised?
BACKGROUND
Struma ovarii is an ovarian teratoma, represented in more than 50% by thyroid tissue. Five percent of struma ovarii cases have been proven to be malignant and, as in the thyroid gland, papillary thyroid carcinoma is the most common histotype arising in struma ovarii. Because of the unusual occurrence of this tumor, its management and follow-up after pelvic surgery is still controversial. Usually, total thyroidectomy followed by radioiodine treatment is the choice treatment in metastatic malignant struma ovarii, while these procedures are still controversial in non-metastatic thyroid cancer arising in struma ovarii.


METHODS
We report a female with follicular variant of papillary thyroid carcinoma arising in struma ovarii. After pelvic surgery, thyroid morphofunctional examinations were performed and a single nodular lesion in the left lobe was discovered. The patient underwent total thyroidectomy and histological examination showed a papillary carcinoma. Radioiodine-ablation of residual thyroid tissue was performed and levothyroxine mildly-suppressive treatment was started.


CONCLUSIONS
A more aggressive treatment should not be denied for malignant struma ovarii without any evidence, even when apparently confined into the ovary. However, in selected cases, aggressive treatment may be advisable to decrease the risk of recurrence and to allow an accurate follow-up.
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy.
Nunzia
N
Brusca
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy.
Susanna Carlotta
SC
Del Duca
Department of Nuclear Medicine, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Rita
R
Salvatori
Department of Nuclear Medicine, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Antonio
A
D'Agostini
Department of Nuclear Medicine, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Pina
P
Cannas
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy.
Maria Giulia
MG
Santaguida
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy.
Camilla
C
Virili
Endocrinology Unit, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Loredana
L
Bianchi
Endocrinology Unit, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Lucilla
L
Gargano
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy ; Endocrinology Unit, Santa Maria Goretti Hospital, AUSL Latina, Latina, Italy.
Marco
M
Centanni
Struma Ovarii; Thyroid Carcinoma; Thyroidectomy