{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:53Z","timestamp":1784557073214,"version":"3.55.0"},"reference-count":11,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"\n Summary<\/jats:title>\n \n A 33-year-old female presented in 2013 with left flank pain. Ultrasound and MRI pelvis showed a complex mass 9 \u00d7 7 cm arising from the left ovary suggestive of ovarian torsion. She underwent a laparoscopic cystectomy, but the patient was lost to follow-up. Three years later, she presented with abdominal distension. Ultrasound and CT scan revealed a solid left ovarian mass with ascites and multiple peritoneal metastasis. Investigations showed elevated CA 125, CA 19-9. Ovarian malignancy was suspected. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy on November 2016. The histopathology confirmed a well-differentiated thyroid cancer of ovarian origin with features of a papillary follicular variant without evidence of ovarian cancer and the thyroglobulin (Tg) level was elevated, more than 400 consistent with the diagnosis of malignant struma ovarii. The follow-up post-surgery showed normalization of CA 125, CA 19-9 and Tg. The patient underwent total thyroidectomy on January 2017. The histology was benign excluding thyroid cancer metastases to the ovary. She was started on thyroxine suppression, following which she received two ablation doses\n 131<\/jats:sup>\n iodine (\n 131<\/jats:sup>\n I) each 5.3 GBq. The Tg remains slightly elevated at less than 10.\n 131<\/jats:sup>\n I WBS showed no residual neck uptake and no distant avid metastasis. She was planned for molecular analysis which may indicate disease severity. We describe a case of malignant struma ovarii with widespread metastatic dissemination and a good response to surgery and\n 131<\/jats:sup>\n I treatment without recurrence after 5 years of follow-up. The Tg remains slightly elevated indicating minimal stable residual disease.\n <\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n Malignant struma ovarii is a rare disease; diagnosis is difficult and management is not well defined.<\/jats:p>\n <\/jats:list-item>\n \n Presentation may mimic advanced carcinoma of the ovary.<\/jats:p>\n <\/jats:list-item>\n \n Predominant sites of metastasis are adjacent pelvic structures.<\/jats:p>\n <\/jats:list-item>\n \n \n Thyroidectomy and\n 131<\/jats:sup>\n iodine therapy should be considered. The management should be similar to that of metastatic thyroid cancer.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-21-0169","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T12:36:16Z","timestamp":1666269376000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":3,"title":["Papillary follicular variant thyroid cancer in a malignant struma ovarii: a report of a rare case"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0690-6527","authenticated-orcid":true,"given":"Omayma","family":"Elshafie","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moza","family":"Al Kalbani","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Al Hamadani","sequence":"additional","affiliation":[{"name":"Department of Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abir","family":"Bou Khalil","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Woodhouse","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Cureus","first-page":"e17360","article-title":"Papillary carcinoma in struma ovarii: a radiological dilemma","volume":"13","author":"Thomas","year":"2021","unstructured":"Thomas JJMaheshwari SAlwaheedy M. Papillary carcinoma in struma ovarii: a radiological dilemma. Cureus202113e17360. (https:\/\/doi.org\/10.7759\/cureus.17360)"},{"key":"bib2","series-title":"Frontiers in Oncology","doi-asserted-by":"publisher","first-page":"645156","DOI":"10.3389\/fonc.2021.645156","article-title":"The clinical and pathological characteristics of malignant struma ovarii: an analysis of 144 published patients","volume":"11","author":"Cui","year":"2021","unstructured":"Cui YYao JWang SZhao JDong JLiao L. The clinical and pathological characteristics of malignant struma ovarii: an analysis of 144 published patients. Frontiers in Oncology202111645156. (https:\/\/doi.org\/10.3389\/fonc.2021.645156)10.3389\/fonc.2021.645156"},{"key":"bib3","series-title":"Journal of Cancer Research","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2013\/717584","article-title":"Clinical finding and thyroid function in women with struma ovarii","volume":"2013","author":"Hosseini","year":"2013","unstructured":"Hosseini AMoeini A. Clinical finding and thyroid function in women with struma ovarii. Journal of Cancer Research201320131\u20134. (https:\/\/doi.org\/10.1155\/2013\/717584)10.1155\/2013\/717584"},{"key":"bib4","series-title":"Endocrinology, Diabetes and Metabolism Case Reports","first-page":"20-0142","article-title":"An unusual case of struma ovarii","volume":"2021","author":"Koehler","year":"2021","unstructured":"Koehler VFKeller PWaldmann ESchwenk NKitzberger CSchmohl KAKnosel TStief CGSpitzweg C. An unusual case of struma ovarii. Endocrinology, Diabetes and Metabolism Case Reports2021202120-0142. (https:\/\/doi.org\/10.1530\/EDM-20-0142)"},{"key":"bib5","series-title":"Pathology Research International","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4061\/2010\/352476","article-title":"A case of papillary thyroid carcinoma in struma ovarii and review of the literature","volume":"2010","author":"Salman","year":"2010","unstructured":"Salman WDSingh MTwaij Z. A case of papillary thyroid carcinoma in struma ovarii and review of the literature. Pathology Research International201020101\u20135. (https:\/\/doi.org\/10.4061\/2010\/352476)10.4061\/2010\/352476"},{"key":"bib6","series-title":"Thyroid Research","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13044-018-0054-9","article-title":"The largest reported papillary thyroid carcinoma arising in struma ovarii and metastasis to opposite ovary: case report and review of literature","volume":"11","author":"Al Hassan","year":"2018","unstructured":"Al Hassan MSSaafan TEl Ansari WAl Ansari AAZirie MAFarghaly HAbdelaal A. The largest reported papillary thyroid carcinoma arising in struma ovarii and metastasis to opposite ovary: case report and review of literature. Thyroid Research20181110. (https:\/\/doi.org\/10.1186\/s13044-018-0054-9)10.1186\/s13044-018-0054-9"},{"key":"bib7","series-title":"Clinical Diabetes and Endocrinology","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40842-018-0064-5","article-title":"Rare clinical entity: metastatic Malignant struma ovarii diagnosed during pregnancy \u2013 lessons for management","volume":"4","author":"Lager","year":"2018","unstructured":"Lager CJKoenig RJLieberman RWAvram AM. Rare clinical entity: metastatic Malignant struma ovarii diagnosed during pregnancy \u2013 lessons for management. Clinical Diabetes and Endocrinology2018413. (https:\/\/doi.org\/10.1186\/s40842-018-0064-5)10.1186\/s40842-018-0064-5"},{"key":"bib8","series-title":"Endocrinology, Diabetes and Metabolism Case Reports","first-page":"19-0130","article-title":"Malignant struma ovarii with a robust response to radioactive iodine","volume":"2020","author":"Gild","year":"2020","unstructured":"Gild MLHeath LPaik JYClifton-Bligh RJRobinson BG. Malignant struma ovarii with a robust response to radioactive iodine. Endocrinology, Diabetes and Metabolism Case Reports2020202019-0130. (https:\/\/doi.org\/10.1530\/EDM-19-0130)"},{"key":"bib9","series-title":"Journal of Clinical and Diagnostic Research","first-page":"140","article-title":"Struma ovarii with elevated CA-125 levels and ascites mimicking advanced CA ovary","volume":"8","author":"Sinha","year":"2014","unstructured":"Sinha NKStruma ovarii with elevated CA-125 levels and ascites mimicking advanced CA ovary. Journal of Clinical and Diagnostic Research20148140\u2013141. (https:\/\/doi.org\/10.7860\/JCDR\/2014\/8005.4138)"},{"key":"bib10","series-title":"Gynecologic Oncology","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1006\/gyno.1995.1224","article-title":"Ovarian strumal carcinoid with markedly high serum levels of tumor markers","volume":"58","author":"Takemori","year":"1995","unstructured":"Takemori MNishimura RSugimura KObayashi CYasuda D. 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