Clinical Medicine: Oncology
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Clinical Medicine: Oncology is an international peer reviewed open access journal which publishes articles on all aspects of cancer research and treatment. Of particular interest are the following topics:- Molecular biology
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Malignant Struma Ovarii: Good Response after Thyroidectomy and 131I Ablation Therapy
Erica W.M. Janszen1, Helena C. van Doorn1, Patricia C. Ewing2, Ronald R. de Krijger2, Johannes H.W. de Wilt3, Boen L.R. Kam4 and Wouter W. de Herder5
1Department of Obstetrics and Gynecology, sector of gynecologic oncology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. 2Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands. 3Department of Surgery, sector of surgical oncology, Erasmus Medical Center, Daniel den Hoed Clinic, Rotterdam. 4Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam. 5Department of Internal Medicine, Sector of endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract
Background: Malignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature.
Cases: We present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and ¹³¹I ablation therapy, two patients as fi rst line management, one following the occurrence of metastatic disease.
Conclusion: Histological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine (¹³¹I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine (¹²³I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.
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