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Case Reports
. 2022 May 17;15(5):e247697.
doi: 10.1136/bcr-2021-247697.

Metastatic follicular carcinoma arising from struma ovarii

Jia Deng  1 , Yang Huang Grace Ng  2 , Sung Hock Chew  3 , Yong Kuei Lim  4
Affiliations
Case Reports

Metastatic follicular carcinoma arising from struma ovarii

Jia Deng et al. BMJ Case Rep. .

Abstract

Struma ovarii (SO) is an uncommon monodermal teratoma predominantly composed of mature thyroid tissue. Approximately 5% of SO are malignant; however, metastases are rare. A single female in her 40s, with a medical history of Graves' disease and bilateral cystectomy 10 years prior for right endometriotic cyst and left SO, presented with an enlarging abdominal mass for 4 months. Ultrasound pelvis showed a 13.8 cm left adnexal heterogeneous solid-cystic mass with internal septations and vascularity. She underwent open left salpingo-oophorectomy and resection of fibrous nodules from the right infundibulo-pelvic ligament and fallopian tube. Histology showed highly differentiated metastatic follicular carcinoma. She subsequently underwent total thyroidectomy, total hysterectomy, right salpingo-oophorectomy, tumour debulking and omentectomy followed by radioactive iodine treatment. Four-year follow-up did not show tumour recurrence or metastases. Due to its rarity, there are no well-established guidelines for the management and follow-up of metastatic follicular carcinoma arising from SO.

Keywords: Gynecological cancer; Obstetrics and gynaecology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Ultrasound image of ovarian mass showing internal septations (arrow).
Figure 2
Figure 2
Ultrasound image of ovarian mass with internal vascularity (arrow).
Figure 3
Figure 3
Left ovarian tumour composed of well-formed thyroid follicles, indistinguishable from struma ovarii.
Figure 4
Figure 4
Omental nodule of thyroid tissue consistent with metastatic highly differentiated follicular carcinoma.
See this image and copyright information in PMC

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