Struma ovarii is a rare ovarian teratoma characterized by the presence of thyroid tissue as the major component. Malignant transformation of the thyroidal component (malignant struma ovarii) has been reported in approximately 5% of struma ovarii. The management and follow-up of this unusual disease remain controversial. We report the case of a woman with a history of autoimmune thyroiditis and a previous resection of a benign struma ovarii that underwent hystero-annexiectomy for malignant struma ovarii with multiple papillary thyroid cancer foci and peritoneal involvement. Total thyroidectomy and subsequent radioiodine treatment lead to complete disease remission after 104 months of follow-up. The diagnosis and natural progression of malignant struma ovarii are difficult to discern, and relapses can occur several years after diagnosis. A multidisciplinary approach is mandatory; after surgical excision of malignant struma, thyroidectomy in combination with 131 I therapy should be considered after risk stratification in accordance with a standard approach in differentiated thyroid cancer patients.
CITATION STYLE
Russo, M., Marturano, I., Masucci, R., Caruso, M., Fornito, M. C., Tumino, D., … Pellegriti, G. (2016). Metastatic malignant struma ovarii with coexistence of Hashimoto’s thyroiditis. Endocrinology, Diabetes & Metabolism Case Reports, 2016. https://doi.org/10.1530/edm-16-0030
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