Histologically bland "extremely well differentiated" thyroid carcinomas arising in struma ovarii can recur and metastasize Journal Article

  

Authors:	Garg, K.; Soslow, R. A.; Rivera, M.; Tuttle, M. R.; Ghossein, R. A.
Article Title:	Histologically bland "extremely well differentiated" thyroid carcinomas arising in struma ovarii can recur and metastasize
Abstract:	Struma ovarii (SO) infrequently harbor carcinomas that are histologically similar to those arising in the eutopic thyroid. We identified 10 such cases in our files. Eight patients presented with pelvic-related symptoms whereas 2 were incidentally discovered during pregnancy, all with disease confined to the ovary. There were 8 papillary thyroid carcinomas (PTCs) (2 classic and 6 follicular variant) and 2 poorly differentiated thyroid carcinomas. Two of the 10 thyroid carcinomas relapsed after an initial diagnosis of "benign" struma. Both occurred in young women with ovarian cysts discovered during pregnancy. The cystectomy from 1 patient showed thyroid follicles with nuclear features of the follicular variant of PTC whereas the cyst from the second patient showed thyroid follicles with subtle nuclear features, suggestive but not diagnostic of PTC. Both patients presented with disseminated PTC 3 and 4 years after the initial diagnosis, involving the pelvis in both cases and also the liver parenchyma in 1 case. The 2 patients received radioactive iodine therapy after thyroidectomy and are both alive with disease 6 years after diagnosis. The criteria separating hyperplastic nodules from well-differentiated follicular variant of PTC in the thyroid gland seem to be applicable to thyroid-type carcinomas arising in SO. The propensity for adverse clinical behavior does not seem to be related to the grade or histologic type of carcinoma in this small series. The hormonal milieu during pregnancy may lead to progression of malignant SO and such patients should be closely followed, particularly if their treatment consists of cystectomy alone. © 2009 International Society of Gynecological Pathologists.
Keywords:	clinical article; controlled study; human tissue; histopathology; cancer recurrence; hysterectomy; salpingooophorectomy; ovarian neoplasms; metastasis; neoplasm recurrence, local; tumor volume; ovariectomy; cancer invasion; radioactive iodine; cystectomy; thyroidectomy; pregnancy; teratoma; thyroid carcinoma; thyroid neoplasms; liver parenchyma; neoplasms, multiple primary; malignant; struma ovarii; thyroid follicle; thyroid papillary carcinoma; iodine isotopes; pregnancy complications, neoplastic
Journal Title:	International Journal of Gynecological Pathology
Volume:	28
Issue:	3
ISSN:	0277-1691
Publisher:	Lippincott Williams & Wilkins
Date Published:	2009-05-01
Start Page:	222
End Page:	230
Language:	English
DOI:	10.1097/PGP.0b013e31818a2b99
PUBMED:	19620939
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-69049104151&partnerID=40&md5=302459b243ae6ecc2e7a234da0fb70c8
Notes:	--- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: IJGPD" - "Source: Scopus"

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