PDF(Pubmed)
Abstract：
UNASSIGNED: Struma ovarii is a highly specialized teratoma consisting primarily of mature thyroid tissue. However, malignant struma ovarii coexisting with thyroid carcinoma, not to mention autoimmune disease, is uncommon. Malignant struma ovarii complicated with papillary thyroid carcinoma, Hashimoto\'s thyroiditis and polycystic ovarian syndrome has never been reported in literature.
UNASSIGNED: A 32-year-old female was admitted to our hospital due to a history of abdominal distension and menolipsis over the past half a year. Physical examination touched a 6 × 6 cm mass with a clear boundary, normal movement, and no pressing pain in the right adnexal area, Imaging revealed a cystic solid mass of 6 × 7 cm in the right ovary and the level of tumor markers including CA125, CA199, CA153, CEA, AFP were normal, but with low TSH and increased TPOAb, TGAb, TRAb. Laparoscopic right ovary tumor resection was performed, followed by comprehensive staging surgery, as well as thyroidectomy after pathologic diagnosis. The patient was diagnosed with a combination of follicular thyroid cancer from struma ovarii, papillary thyroid carcinoma and Hashimoto\'s thyroiditis, along with polycystic ovarian syndrome. Immunohistochemical staining showed positivity for Ag, CK-pan, CK7, PAX8 and TTF-1 in the right ovarian mass, and the left thyroid was positive for the BRAF V600E mutation.
UNASSIGNED: The patient underwent thyroxine suppression therapy and radioactive iodine 131I therapy after operation. Serum thyroglobulin was undetectable, and no signs of recurrence or metastasis were detected in the imaging examination at the 2-year follow-up.
UNASSIGNED: Malignant struma ovarii coexisting with thyroid carcinoma is rare. No report has been identified in literature review on the rare malignant struma ovarii coexisting with thyroid carcinoma, Hashimoto\'s thyroiditis and polycystic ovarian syndrome. Our case can offer experience of diagnosis and treatment to some extent for such rare case. Therefore, it is essential to consider the association between ovarian tumors and the endocrine system. This case is valuable in understanding the diagnosis and management of such an unusual complicated disease.
UNASSIGNED: A 32-year-old female was admitted to our hospital due to a history of abdominal distension and menolipsis over the past half a year. Physical examination touched a 6 × 6 cm mass with a clear boundary, normal movement, and no pressing pain in the right adnexal area, Imaging revealed a cystic solid mass of 6 × 7 cm in the right ovary and the level of tumor markers including CA125, CA199, CA153, CEA, AFP were normal, but with low TSH and increased TPOAb, TGAb, TRAb. Laparoscopic right ovary tumor resection was performed, followed by comprehensive staging surgery, as well as thyroidectomy after pathologic diagnosis. The patient was diagnosed with a combination of follicular thyroid cancer from struma ovarii, papillary thyroid carcinoma and Hashimoto\'s thyroiditis, along with polycystic ovarian syndrome. Immunohistochemical staining showed positivity for Ag, CK-pan, CK7, PAX8 and TTF-1 in the right ovarian mass, and the left thyroid was positive for the BRAF V600E mutation.
UNASSIGNED: The patient underwent thyroxine suppression therapy and radioactive iodine 131I therapy after operation. Serum thyroglobulin was undetectable, and no signs of recurrence or metastasis were detected in the imaging examination at the 2-year follow-up.
UNASSIGNED: Malignant struma ovarii coexisting with thyroid carcinoma is rare. No report has been identified in literature review on the rare malignant struma ovarii coexisting with thyroid carcinoma, Hashimoto\'s thyroiditis and polycystic ovarian syndrome. Our case can offer experience of diagnosis and treatment to some extent for such rare case. Therefore, it is essential to consider the association between ovarian tumors and the endocrine system. This case is valuable in understanding the diagnosis and management of such an unusual complicated disease.
摘要：
■卵巢Struma是一种高度特化的畸胎瘤，主要由成熟的甲状腺组织组成。然而,恶性卵巢甲状腺肿与甲状腺癌并存，更不用说自身免疫性疾病了，是不常见的。恶性卵巢甲状腺肿合并甲状腺乳头状癌,桥本氏甲状腺炎和多囊卵巢综合征从未见文献报道。
■一名32岁女性因过去半年的腹胀和月经不调病史入院。体格检查触及6×6厘米的肿块，边界清晰，正常运动,右附件区域没有压迫性疼痛，影像学显示右侧卵巢囊性实性肿块6×7cm，肿瘤标志物水平包括CA125，CA199，CA153，CEA，AFP正常,但是TSH低和TPOAb增加，TGAb,TRAb.腹腔镜右卵巢肿瘤切除术，其次是全面的分期手术，以及病理诊断后的甲状腺切除术。该患者被诊断为卵巢甲状腺肿合并滤泡性甲状腺癌，甲状腺乳头状癌和桥本氏甲状腺炎，还有多囊卵巢综合征.免疫组织化学染色显示Ag阳性，CK-Pan,正确卵巢肿块中的CK7，PAX8和TTF-1，左侧甲状腺BRAFV600E突变阳性。
■患者术后接受甲状腺素抑制治疗和放射性碘131I治疗。血清甲状腺球蛋白检测不到，随访2年，影像学检查未发现复发或转移迹象。
■恶性卵巢甲状腺肿与甲状腺癌并存罕见。罕见的恶性卵巢甲状腺肿与甲状腺癌并存的文献综述未见报道。桥本氏甲状腺炎和多囊卵巢综合征。我们的病例可以在一定程度上为此类罕见病例提供诊断和治疗经验。因此,必须考虑卵巢肿瘤与内分泌系统之间的关联.这种情况对于理解这种异常复杂疾病的诊断和管理很有价值。
■一名32岁女性因过去半年的腹胀和月经不调病史入院。体格检查触及6×6厘米的肿块，边界清晰，正常运动,右附件区域没有压迫性疼痛，影像学显示右侧卵巢囊性实性肿块6×7cm，肿瘤标志物水平包括CA125，CA199，CA153，CEA，AFP正常,但是TSH低和TPOAb增加，TGAb,TRAb.腹腔镜右卵巢肿瘤切除术，其次是全面的分期手术，以及病理诊断后的甲状腺切除术。该患者被诊断为卵巢甲状腺肿合并滤泡性甲状腺癌，甲状腺乳头状癌和桥本氏甲状腺炎，还有多囊卵巢综合征.免疫组织化学染色显示Ag阳性，CK-Pan,正确卵巢肿块中的CK7，PAX8和TTF-1，左侧甲状腺BRAFV600E突变阳性。
■患者术后接受甲状腺素抑制治疗和放射性碘131I治疗。血清甲状腺球蛋白检测不到，随访2年，影像学检查未发现复发或转移迹象。
■恶性卵巢甲状腺肿与甲状腺癌并存罕见。罕见的恶性卵巢甲状腺肿与甲状腺癌并存的文献综述未见报道。桥本氏甲状腺炎和多囊卵巢综合征。我们的病例可以在一定程度上为此类罕见病例提供诊断和治疗经验。因此,必须考虑卵巢肿瘤与内分泌系统之间的关联.这种情况对于理解这种异常复杂疾病的诊断和管理很有价值。
