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. 2021 Mar 5:11:645156.
doi: 10.3389/fonc.2021.645156. eCollection 2021.

The Clinical and Pathological Characteristics of Malignant Struma Ovarii: An Analysis of 144 Published Patients

Yuying Cui  1   2 , Jinming Yao  1   3 , Shengnan Wang  1 , Junyu Zhao  1 , Jianjun Dong  4 , Lin Liao  1   3
Affiliations

The Clinical and Pathological Characteristics of Malignant Struma Ovarii: An Analysis of 144 Published Patients

Yuying Cui et al. Front Oncol. .

Abstract

The objective of this study is to summarize the clinical and pathologic characteristics of malignant struma ovarii to facilitate the early diagnosis and treatment of this disease. All 144 patients were females from 27 countries. The mean age of the patients at diagnosis was 42.6 years. Overall, 35.71% of the patients underwent unilateral oophorectomy, 58.57% of the patients underwent bilateral oophorectomy, 5.72% of the patients were not ovariectomized, and 38.57% of the patients received radioactive iodine treatment with an average dose of 158.22 mCI each time. "Impure" types accounted for 70.19% of the cases, while pure types accounted for 29.81% of the cases. Among these cases, papillary thyroid carcinoma accounted for 50.00%, follicular thyroid carcinoma accounted for 26.47%, follicular variant of papillary thyroid carcinoma accounted for 18.63%, papillary and follicular mixed thyroid carcinoma accounted for 2.94%, anaplastic carcinoma accounted for 0.98%, and medullary carcinoma accounted for 0.98%. In total, 21 patients (51.22%) had elevated CA125. More than half of the patients (51.94%) had metastasis outside the ovary. The most common metastatic site was the pelvic cavity. The misdiagnosis rate was 17.27%. Mortality was related to metastasis and the cancer type. Gene mutations were found in the NRAS, KRAS, BRAF, and KIT genes and were similar to those in thyroid carcinoma, but some patients (37.5%) did not exhibit any gene mutations. Regardless of the treatment received, the survival rate is high. Treatment could initially include ovariectomy; however, in cases with metastasis and iodine uptake of the metastatic tumor, thyroidectomy, radioactive iodine therapy, and thyroid hormone inhibiting therapy are indicated.

Keywords: endocrine tumor; epidemiology; gynecologic oncology; malignant struma ovarii; thyroid cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Literature review inclusion process.
Figure 2
Figure 2
Patients' age distribution; a one-sample Kolmogorov-Smirnov test confirms that the age distribution follows a normal distribution.
Figure 3
Figure 3
(A) Geographical country distribution ratio among the patients (%). (B) Continent distribution ratio among the patients (%).
See this image and copyright information in PMC

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