Isolated Scapular Metastasis in a Patient with Malignant Struma Ovarii: A Case Report.

CASE: We report the case of a 38-year-old woman who presented with a lytic bone lesion in the left scapula. A biopsy showed a tumor with the histologic appearance of thyroid tissue. She also was found to have a thyroid nodule and an enlarged ovary, both of which were excised. The thyroid nodule turned out to be a benign colloid nodule, and the ovary contained a monodermal teratoma composed of thyroid tissue (struma ovarii). The lesion in the scapula eventually was proven to be metastatic malignant struma ovarii. CONCLUSION: Malignant struma ovarii with bone metastases is very rare, and its diagnosis is a challenge. There are some documented cases with bone metastases, mostly to the thoracic and lumbar spine. The optimal treatment of choice for the bone lesion is unknown because of the rarity of its presentation.

SPECT/CT of metastatic struma ovarii.

A 41-year-old woman presented with multiple right lower quadrant masses which were removed and consistent with metastatic follicular thyroid cancer. Thyroidectomy revealed no primary malignancy and evaluation of her ovaries was positive for struma ovarii. The patient was diagnosed with metastatic struma ovarii stage IV. Nine days following the patient's second therapy with I for recurrent disease, planar and SPECT/CT imaging demonstrated multiple I avid peritoneal nodules. At least one of them, located along the medial margin of the spleen, would have been difficult to diagnose without hybrid SPECT/CT imaging.

131I therapy using rhTSH stimulation and dosimetry in metastatic malignant struma ovarii.

A 38-year-old woman with metastatic malignant struma ovarii, including massive liver metastases and retroperitoneal lymphadenopathy, underwent ovarian resection and retroperitoneal lymph nodes excision, partial hepatectomy, and radiofrequency ablation for liver metastases. She underwent thyroidectomy and received three I treatments using recombinant human thyrotropin stimulation and radioiodine dosimetry. posttherapy I imaging, anatomic images, and thyroglobulin levels showed significant diminution in the tumor burdens and remarkable decline in thyroglobulin levels. This case provided valuable information on recombinant human thyrotropin-assisted I ablation in conjunction with dosimetry in an unusual presentation of iodine-avid malignant struma ovarii with bulky metastases.

[Somatotropic pituitary tumor in a patient with a previous ovarian strumal carcinoid. Report of one case]. / Adenoma hipofisiario productor de somatotrofina en una paciente con antecedente de struma ovarii carcinoide.

Strumal carcinoid is an unusual form of monodermal ovarian teratoma with thyroid-like follicles mixed with typical carcinoid tumor patterns. We report a 49 years old woman presenting with an acromegaly. At the age of 45, an ovarian strumal carcinoid was excised and at three years of follow up, she complained of finger and feet growth. Laboratory showed an elevated serum IGF-1 and a sella turcica magnetic resonance imaging showed an 8 mm microadenoma. She was subjected to a transphenoidal excision and the pathological study disclosed a solid acidophilic pituitary adenoma. Two months after surgery, there was a significant decrease in serum IGT-I levels.

Malignant Struma Ovarii: an autopsy report of a clinically unsuspected tumor.

BACKGROUND: Struma Ovarii represents less than 3% of ovarian teratomas. The malignant counterpart is very rare. CASE: A 67-year-old female with ascites and progressive weight loss died of respiratory failure secondary to severe chronic obstructive pulmonary disease. Autopsy revealed ascites, hepatic cirrhosis, emphysema, and bronchiectasis. As an incidental finding was seen a huge tumor (10 x 9.5 x 6 cm) in the left ovary. Multiple nodules were detected in the lungs. The thyroid was normal. Microscopy revealed a follicular variant of papillary carcinoma arising in ectopic thyroid tissue in the ovary with metastasis to lungs and pleura. The thyroid gland tissue was normal. CONCLUSION: To our knowledge, this is the first autopsy report of a clinically unsuspected malignant Struma Ovarii.

Cystic struma ovarii: a rare presentation of an infrequent tumor.

CONTEXT: Struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. It is generally considered to account for less than 5% of mature teratomas. CASE REPORT: A diagnosis of struma ovarii may be the source of many diagnostic problems. It may be cystic and microscopic examination may only reveal a few typical thyroid follicles, resulting in confusion with other cystic ovarian tumors. Extensive sampling should be undertaken and immunohistochemistry may be decisive in establishing the thyroid nature of the epithelial lining. The authors report two cases of cystic struma ovarii, and discuss diagnostic criteria and the limitations of frozen biopsies in these tumors.

Cystic struma ovarii: a rare presentation of an infrequent tumor

CONTEXT: Struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. It is generally considered to account for less than 5 percent of mature teratomas. CASE REPORT: A diagnosis of struma ovarii may be the source of many diagnostic problems. It may be cystic and microscopic examination may only reveal a few typical thyroid follicles, resulting in confusion with other cystic ovarian tumors. Extensive sampling should be undertaken and immunohistochemistry may be decisive in establishing the thyroid nature of the epithelial lining. The authors report two cases of cystic struma ovarii, and discuss diagnostic criteria and the limitations of frozen biopsies in these tumors

[Struma ovarii: a variety of monodermic teratoma of the ovary. Report of 8 cases]. / Struma ovarii: una variedad de teratoma monodérmico del ovario. Informe de ocho casos.

Inside the germinal neoplasms of the ovary, the monodermic or specializad teratomas constitute a not very frequent variety. The struma ovarii represents 2.7% as the form more common of this teratomas type, constituted by thyroid tissue. Struma ovarii can associate to other tumors of the ovary of germinal type as dermoid cyst, carcinoid tumor or non germinal tumors as type as dermoid cyst, carcinoid tumor or non germinal tumors as mucinous or serous cyst or Brenner tumor. Most of the struma ovarii are benign and 5-10% only are malignant, of these group 40% has only associated to extraovaric dissemination. The objective of the present work is to analyze the clinical, epidemical and biological characteristics of the struma ovarii. Eight cases of struma ovarii are presented, that occupy 4% inside the ovary tumors diagnosed and treated in our hospital. The clinical charac-teristics of these tumors were: age average 45.5 tears, pelvic mass accompanied by distension and abdominal pain. They were managed as anyone ovary tumor, in not any case the diagnosis it was suspected, 4 were presented of the left side and 4 in the right, the weight average was 726.2 g. Only in 4 cases was carried out the transoperative diagnosis and the eight cases confirmed in the postoperative. In not any case hyperthyroid symptoms, neither morphological criteria of malignancy were presented. Only in two cases the struma ovarii was reported as pure, in the 6 remaining it is accompanied with another type of ovarian neoplasm.

Microscopia electrónica de barrido del estroma de la vellosidad molar / Seanning election microscopy of the stoma of vesicles of a hydiatidiform mole

Objetivo. Visualizar el estroma de las vesículas de una mola hidatidiforme en el segundo trimestre del embarazo en forma tridimensional con técnicas de microscopia electrónica de barrido y compararlas con las bellosidades de un aborto de la misma edad. Método: Se utilizó la técnica convecional de hematoxilina -eosina, microscopia electrónica de barrido y microscopia de luz. Ambiente: Centro de Investigación y Análisis Docente Asistencial del Núcleo Aragua. Facultad de Ciencias de la Salud. Universidad de Carabobo. Maracay, Estado Aragua. Resultados: Indican 5 formas de organizarse el estroma. Conclusión: La disposición del estroma en esta variable morfológica, da una nueva visión tridimensional de la citoarquitectura del estroma de la vellosidad molar

Tumores de los cordones sexuales y del estroma ovárico: estudio clínico-patológico / Tumors of the cords and ovarian stroma: clinic-pathologic study

En el presente estudio descriptivo y retrospectivo, realizado en la Sección de Ginecopatología del Instituto de Anatomía Patológica Dr. José O'Daly UCV en el lapso comprendido entre 1985 y 1995, se encontraron 32 tumores de los cordones sexuales y del estroma ovárico, distribuidos de la siguiente manera, dentro del grupo de los tumores estromales de la granulosa: un tumor de la granulosa variedad adulta, tres de la granulosa variedad juvenil, tres tecomas, 6 fibromas, 9 fibrotecomas y tres tumores esclerosantes del estroma, con un total de 25 casos: en el segundo grupo correspondiente a los tumores de las células de sértoli, se encontraron 5 en total, 3 de diferenciación intermedia y elementos heterólogos y 2 de diferenciación intermedia y patrón retiforme y en el grupo de los ginandroblastoma y otro con túbulos anulares. La mayoría de estos tumores se presentó en mujeres mayores de 40 años, a excepción del grupo de la granulosa juvenil, donde todas las pacientes tenían menos de 25 años. El motivo de consulta más frecuente fué dolor abdominal, seguido por una masa o aumento de volumen abdominal en un porcentaje de 37,5 por ciento y 34,4 por ciento respectivamente. Al momento del diagnóstico, el 96 por ciento se encontraba en estado clínico I y un seguimiento, a los 8 años, libre de enfermedad. El tratamiento quirúrgico de elección fué la ooforectomía unilateral en un 60 por ciento. En nuestros casos, los tumores más frecuentes fueron los del grupo de los tumores estromales de la granulosa, representados por los fibrotecomas y entre los tumores de la granulosa predominó el de la variedad juvenil

Morphology of the human ovary in the course of the postmenopausal period

Estudiando la morfología del ovario en diferentes fases del período de la post-menopausia (de 1 a 5 años y con 11 años o más de menopausia), los autores observaron actividad folicular de tipo cístico o involutivo hasta 10 años después de la menopausia. Los hallazgos histológicos principales fueron la esclerosis de vasos sanguíneos y la fibrosis del estroma ovárico y cuerpos albicantes no reabsorbidos que fueron encontrados en los tres grupos estudiados. Otra característica importante es el proceso de hiperplasia del estroma, que parece ser responsable de la esteroidegénesis del ovario atrófico y que podría estar involucrado en la formación de tumores del sistema reproductor femenino

Struma ovarii benigno / Benign struma ovarii

Säo descritos dois casos de struma ovarii benignos examinados e tratados no Departamento de Ginecologia do Hospital A.C. Camargo da Fundaçäo Antônio Prudente. O diagnóstico anatomopatológico de congelaçäo já demonstrava histopatologia sugestiva de struma ovarii, ratificado posteriormente através do exame com parafina. Procedeu-se ainda ao estudo com imunoperoxidase (antitiroglobulina), como propedêutica complementar. Os aspectos clínicos diferenciais e tratamento deste tumor raro säo discutidos

Struma ovarii: relato de dois casos / Struma ovarii: report of 2 cases

Säo apresentados dois casos de pacientes portadoras de Struma ovarii. O Struma ovarii representa um teratoma ovariano de desenvolvimento unilateral no qual predomina como componente o tecido tireoidiano. No primeiro caso descrito o Struma apresentou-se associado a um cisto dermóide, com outros elementos teratomatosos, enquanto no segundo se apresentou como no Struma ovarii puro. Ambos foram histologicamente benignos. A fisiologia e suas alteraçöes, assim como a relaçäo do Struma ovarii com a glândula tireóide foram consideradas. Num dos casos descritos houve evidência de sinais tireotóxicos. Conclui-se que o rastreio através da captaçäo de iodo radioativo deve fazer parte do estudo diagnóstico do Struma ovarii, bem como a avaliaçäo da funçäo tireoidiana após sua remoçäo, seja ele histologicamente benigno ou maligno

[Structural and histochemical characterization of a struma ovarii]. / Caracterización estructural e histoquímica de un estruma ovárico.

We have studied the thyroid tissue present in a cystic ovarian teratoma with the purpose of characterizing its structural and histochemical components. The methods of hematoxilyn and eosin, PAS, PAS/sialidase, Alcian blue at pH 2.5 and 1.0, were used, as well as, blocking reactions, Cason's thrichromic, and toluidine blue at pH 3.8. In the tissue we observed zones with follicles of normal appearance that varied considerably in size. The epithelium was constituted by cuboid cells surrounding a colloid substance of uniform aspect, that was strongly acidophilic, PAS positive and with variable reactivity with toluidine blue and weakly alcianophilic. With the thrichrome method, the different follicles stained in different tones. Parafollicular clear cells, bigger and less basophilic than follicular ones, with a nucleus having a lax chromatin, were identified. Cystic follicles were observed in whose cavities were conspicuous histyocytes surrounding rests of colloid substance, with metachromatic and PAS positive granules in their cytoplasm. Some groups of follicles were rudimentary, scarcely differentiated, and mostly without colloid. Others, with a greater degree of differentiation, showed diminutes follicles with intensely basophilic and PAS positive colloid. Beasides, follicular groups with excessive content of colloid appeared very distended and lined by a flat epithelium. According to the characteristics analyzed it may be concluded that: 1) it is a highly differentiated monoblastic teratoma, in which it appears non-encapsulated thyroid tissue; 2) the tumor resembles in different areas, either normal thyroid tissue, thyroid adenoma of the macrofollicular type, fetal or microfollicular and solid or embryonary adenoma, and follicles with the pattern of "thyroiditis".

Caracterización estructural e histoquimica de un estruma ovarico / Structural and histochemical caracterization of an ovarian struma

Hemos estudiado el tejido tiroideo presente en un teratoma quístico de ovario con el objeto de caracterizar sus componentes estructurales y citoquímicos. Se utilizaron los métodos de hematoxilina y eosina. PAS. PAS/sialidasa, blue a pH 2,5 y 1,0, reacciones de bloqueo, tricrómico de Cason, azul de toluidina a pH 3,8 y metenamina/plata. En el mismo hemos observado zonas con folículos de apariencia normal que variaban considerablemente de tamaño. El epitelio estaba constituido por células cuboideas que rodeaban a una sustancia coloide de aspecto uniforme, francamente acidófila, con variable reactividad al azul de toluidina y débilmente alcionofilica. Con el método tricrómico, los diferentes folículos se tiñeron de distintas tonalidades. Se identificaron células claras parafoliculares más grandes y menos basófilas que las foliculares. Se observaron folículos quísticos en cuyas cavidades se destacaban histiocitos rodeando a restos de sustancia coloide, los que tenían granulaciones metacromáticas y PAS positivas en sucitoplasma. algunos grupos de folículos eran rudimentarios, escasamente diferenciados y por lo general sin coloide. Otros, con un grado mayor de diferenciación, mostraban folículos en miniatrura con coloide intensamente basófilo y PAS positivo. Además, aparecían grupos foliculares distendidos, con excesivo contenido coloide y tapizados por un epitelio plano. Según las características analizadas podemos podemos concluir que: 1) se trata de un teratoma monoblástico altamente diferenciado en el que aparece tejido tiroideo no encapsulado; 2) dicho tumor se semeja en diferentes áreas al tejido tiroideo normal, al adenoma tiroideo tipo macrofolicular, microfolicular o fetal, sólido o embrionario, y a folículos con patrón de "tiroiditis"

Caracterización estructural e histoquimica de un estruma ovarico / Structural and histochemical caracterization of an ovarian struma

Hemos estudiado el tejido tiroideo presente en un teratoma quístico de ovario con el objeto de caracterizar sus componentes estructurales y citoquímicos. Se utilizaron los métodos de hematoxilina y eosina. PAS. PAS/sialidasa, blue a pH 2,5 y 1,0, reacciones de bloqueo, tricrómico de Cason, azul de toluidina a pH 3,8 y metenamina/plata. En el mismo hemos observado zonas con folículos de apariencia normal que variaban considerablemente de tamaño. El epitelio estaba constituido por células cuboideas que rodeaban a una sustancia coloide de aspecto uniforme, francamente acidófila, con variable reactividad al azul de toluidina y débilmente alcionofilica. Con el método tricrómico, los diferentes folículos se tiñeron de distintas tonalidades. Se identificaron células claras parafoliculares más grandes y menos basófilas que las foliculares. Se observaron folículos quísticos en cuyas cavidades se destacaban histiocitos rodeando a restos de sustancia coloide, los que tenían granulaciones metacromáticas y PAS positivas en sucitoplasma. algunos grupos de folículos eran rudimentarios, escasamente diferenciados y por lo general sin coloide. Otros, con un grado mayor de diferenciación, mostraban folículos en miniatrura con coloide intensamente basófilo y PAS positivo. Además, aparecían grupos foliculares distendidos, con excesivo contenido coloide y tapizados por un epitelio plano. Según las características analizadas podemos podemos concluir que: 1) se trata de un teratoma monoblástico altamente diferenciado en el que aparece tejido tiroideo no encapsulado; 2) dicho tumor se semeja en diferentes áreas al tejido tiroideo normal, al adenoma tiroideo tipo macrofolicular, microfolicular o fetal, sólido o embrionario, y a folículos con patrón de "tiroiditis" (AU)