Cases reported "Struma Ovarii"

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1/114. Ovarian strumal carcinoid with severe constipation: immunohistochemical and mRNA analyses of peptide yy.

    Functioning ovarian carcinoid tumors are well known to cause carcinoid syndrome. Recently, strumal and trabecular ovarian carcinoid tumors are reported to cause severe constipation possibly because of tumor-producing peptide yy (PYY). We studied a case of primary ovarian strumal carcinoid who had had severe constipation until the tumor was removed by surgical operation. Immunohistochemically, many tumor cells were strongly positive for PYY. By Northern blot and reverse transcription polymerase chain reaction analyses, PYY mRNA was expressed in a complete form as detected in normal human colon mucosa. From these findings, an ovarian strumal carcinoid is strongly suggested to express complete PYY mRNA and therefore complete PYY protein that results in severe constipation. ( info)

2/114. Malignant struma ovarii.

    A rare case of malignant struma ovarii is presented. The tumor was excised together with the ovary and interpreted as a papillary strumal adenocarcinoma arising in a cystic teratoma with predominant thyroid elements. Prior to surgery the patient did not show any symptoms of thyroid hyperfunction. The thyroid function tests performed subsequent to surgery were within normal limits. Periodic examinations of the patient over a period of three years did not reveal any abnormalities. Statistically, this type of malignancy carries a good prognosis with a high "cure" rate. ( info)

3/114. Simultaneous strumal ovarii and lymphoma with emphasis on the diagnostic usefulness of immunohistochemical stains.

    Strumal ovarii has been rarely associated with other tumors, such as carcinoid tumor, carcinoma, and primary ovarian malignant lymphoma. We report the coexistence of a strumal ovarii and ovarian involvement by malignant lymphoma in a 70-year-old woman. The tumors were detected 10 years following exposure to ionizing radiation during the Chernobyl nuclear tragedy. ( info)

4/114. struma ovarii and hyperthyroidism.

    struma ovarii is a teratoma of the ovaries that contains a large amount of thyroid tissue. Like the cervical thyroid gland, this ectopic thyroid tissue can become autonomous. We present a case of hyperthyroidism caused by thyroid tissue in a large ovarian cystic teratoma and provide detailed endocrinological, radiological, and pathological preoperative and postoperative data. This is also the first documented case of struma ovarii in association with a secreting pituitary tumor. In addition, we provide a retrospective pathological analysis of 1390 surgically removed ovarian tumors at 2 major academic centers. ( info)

5/114. Malignant struma ovarii: two case reports and a review of the literature.

    struma ovarii consists of thyroid tissue derived from germ cells in a mature teratoma. Malignant transformation is very rare, with clinically evident metastatic disease reported in approximately 20 cases. The rarity of this disease renders evaluation of treatment modalities difficult. There is evidence that these tumors behave like their thyroid counterparts, and cytoreductive surgery followed by ablation with radioactive iodine has been advocated. We report the diagnosis and treatment of 2 patients with metastatic malignant struma ovarii treated with a combination of surgery and radiation therapy. ( info)

6/114. Strumal carcinoid of ovary. A case report with immunohistochemical investigations.

    Clinical, histological and immunohistochemical findings in a rare ovarian tumor--strumal carcinoid--are presented. neuropeptides detected by immunoreactions revealed the origin of tumor cells from the midgut. Immunohistochemical reaction revealed parathyroid hormone-related protein (PTHrp) in the carcinoid cells. After surgical resection of the tumor a decrease in serum calcium level was observed. ( info)

7/114. Monomorphic teratoma of the ovary: a rare cause of triiodothyronine toxicosis.

    A case of low thyroid radioactive iodine uptake (RAIU) thyrotoxicosis due to a large struma ovarii comprising pure thyroid tissue is presented, including a detailed diagnostic evaluation, histopathology, and demonstration of rapid recovery of native thyroid function after surgical excision. In addition, the first comprehensive analysis of thyroglobulin obtained from an ovarian struma is reported. ( info)

8/114. Follicular carcinoma in a functioning struma ovarii.

    We describe a case of follicular carcinoma in a functioning struma ovarii, which presented as an ovarian mass in a patient who had undergone a near-total thyroidectomy for a benign lesion. She underwent bilateral salpingo-oophorectomy and received radiotherapy and L-thyroxine treatment with no evidence of metastases in 4 years follow-up. ( info)

9/114. Recombinant human thyrotropin for the diagnosis and treatment of a highly functional metastatic struma ovarii.

    The optimal treatment of metastatic thyroid cancer that produces high amounts of thyroid hormone has not been well defined. A 46-yr-old woman presented with a follicular thyroid carcinoma arising from a struma ovarii with hepatic metastases. After the removal of both the struma and the thyroid gland, the liver metastases showed evidence of a high degree of hormonogenesis. brain, chest, abdomen, and bone imaging was negative for additional metastases. Because iodine uptake by most thyroid carcinomas is quite low in the absence of high levels of ambient TSH, we used recombinant human TSH (rhTSH) (Thyrogen) to achieve a concentration of 131I activity in the tumor high enough for a significant cytotoxic effect. After rhTSH administration (0.9 mg im daily for 2 consecutive days), a 131I diagnostic whole body scan confirmed the existence of 17 discrete hepatic foci of 131I uptake. To calculate the amount of 131I that would deliver an absorbed radiation dose that would be optimally cytotoxic to the metastases (>8000 rad/lesion) and not to the normal liver, we performed lesion dosimetry. Analysis of dosimetric data showed that 15 of 17 lesions would receive an adequate radiation dose following the administration of 65 mCi of 131I. Additionally, we performed whole body dosimetry to assure that this dose would not cause bone marrow toxicity. The patient was reevaluated 6 months after therapy; the liver metastases showed significant, but partial, response. In conclusion, we used the combination of rhTSH with lesional and whole body dosimetry for the treatment of highly functional metastases from follicular thyroid carcinoma arising within a struma ovarii. This strategy can be applied to determine a safe and effective dose of 131I for the treatment of any thyroid cancer metastases that produce enough TH to preclude stimulation of endogenous pituitary TSH secretion. ( info)

10/114. 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. ( info)
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