title: Management dilemma of thyroid nodules in patients with malignant struma ovarii.
abstract: Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital. Fine needle aspiration demonstrated benign histology. However, due to compressive symptoms and uncertainty of other nodules, the patient underwent a total thyroidectomy. Due to limited published data and treatment guidelines regarding thyroid nodules in patients with a history of malignant struma ovarii, surgery was recommended to rule out papillary thyroid carcinoma and relieve the patient's dysphagia. More research focused on treatment and outcomes of struma ovarii patients with thyroid nodules is essential to establish treatment guidelines for these patients.
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: Sarah J
authors: SJ
authors: Sternlieb
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: Celine
authors: C
authors: Satija
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: David T
authors: DT
authors: Pointer
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: Byron E
authors: BE
authors: Crawford
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: Lacey
authors: L
authors: Sullivan
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors: Emad
authors: E
authors: Kandil
keywords: Thyroid nodule; struma ovarii