Abstract
Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Restaging with18F-FDG-PET/CT scan, abdominal CT and ultrasonography showed abnormalities in the perihepatic region and presacral space and left hypochondrium localizations. The patient underwent thyroidectomy, hepatic nodulectomy and cytoreductive peritonectomy: histopathological examination did not show any malignant disease in the thyroid and confirmed the presence of peritoneal localizations due to malignant SO; molecular analysis detected NRAS Q61K mutation in exon 3, whereas no mutations were identified on the BRAF gene. The patient underwent radioiodine treatment: serum Tg was decreased at first follow-up after three months of131I-therapy. We believe that our case raises some interesting considerations. First, pathologists should be aware of this entity and should check for the presence of point mutations suggesting an aggressive disease behavior, which could be beneficial for an optimal therapeutic approach. Second, although most of the knowledge in this field comes from case reports, efforts should be made to standardize the management of patients affected by malignant SO, including use of practice guidelines.
| Original language | English |
|---|---|
| Pages (from-to) | 322-327 |
| Number of pages | 6 |
| Journal | Hormones |
| Volume | 16 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jul 1 2017 |
Fingerprint
Keywords
- I-131
- Malignant struma ovarii
- Papillary thyroid carcinoma
- Radioiodine
- Treatment
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
Cite this
Malignant struma ovarii harboring a unique NRAS mutation : Case report and review of the literature. / Gobitti, Carlo; Sindoni, Alessandro; Bampo, Chiara; Baresic, Tanja; Giorda, Giorgio; Alessandrini, Lara; Canzonieri, Vincenzo; Franchin, Giovanni; Borsatti, Eugenio.
In: Hormones, Vol. 16, No. 3, 01.07.2017, p. 322-327.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Malignant struma ovarii harboring a unique NRAS mutation
T2 - Case report and review of the literature
AU - Gobitti, Carlo
AU - Sindoni, Alessandro
AU - Bampo, Chiara
AU - Baresic, Tanja
AU - Giorda, Giorgio
AU - Alessandrini, Lara
AU - Canzonieri, Vincenzo
AU - Franchin, Giovanni
AU - Borsatti, Eugenio
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Restaging with18F-FDG-PET/CT scan, abdominal CT and ultrasonography showed abnormalities in the perihepatic region and presacral space and left hypochondrium localizations. The patient underwent thyroidectomy, hepatic nodulectomy and cytoreductive peritonectomy: histopathological examination did not show any malignant disease in the thyroid and confirmed the presence of peritoneal localizations due to malignant SO; molecular analysis detected NRAS Q61K mutation in exon 3, whereas no mutations were identified on the BRAF gene. The patient underwent radioiodine treatment: serum Tg was decreased at first follow-up after three months of131I-therapy. We believe that our case raises some interesting considerations. First, pathologists should be aware of this entity and should check for the presence of point mutations suggesting an aggressive disease behavior, which could be beneficial for an optimal therapeutic approach. Second, although most of the knowledge in this field comes from case reports, efforts should be made to standardize the management of patients affected by malignant SO, including use of practice guidelines.
AB - Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Restaging with18F-FDG-PET/CT scan, abdominal CT and ultrasonography showed abnormalities in the perihepatic region and presacral space and left hypochondrium localizations. The patient underwent thyroidectomy, hepatic nodulectomy and cytoreductive peritonectomy: histopathological examination did not show any malignant disease in the thyroid and confirmed the presence of peritoneal localizations due to malignant SO; molecular analysis detected NRAS Q61K mutation in exon 3, whereas no mutations were identified on the BRAF gene. The patient underwent radioiodine treatment: serum Tg was decreased at first follow-up after three months of131I-therapy. We believe that our case raises some interesting considerations. First, pathologists should be aware of this entity and should check for the presence of point mutations suggesting an aggressive disease behavior, which could be beneficial for an optimal therapeutic approach. Second, although most of the knowledge in this field comes from case reports, efforts should be made to standardize the management of patients affected by malignant SO, including use of practice guidelines.
KW - I-131
KW - Malignant struma ovarii
KW - Papillary thyroid carcinoma
KW - Radioiodine
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85039713954&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039713954&partnerID=8YFLogxK
U2 - 10.14310/horm.2002.1750
DO - 10.14310/horm.2002.1750
M3 - Article
VL - 16
SP - 322
EP - 327
JO - Hormones
JF - Hormones
SN - 1109-3099
IS - 3
ER -