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Late Bone Metastasis of Histologically Bland Struma Ovarii: The Unpredictability of Its Biologic Behavior.

Oh SJ, Jung M, Kim YO - J Pathol Transl Med (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Kosin University Gospel Hospital, Busan, Korea.

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Struma ovarii (SO) is a subtype of ovarian teratoma that contains mostly thyroid tissue comprising more than 50% of the tumor volume... It is difficult to predict the metastatic potential of SO at initial diagnosis... Even SO that histologically resembles non-neoplastic thyroid tissue is sometimes associated with recurrence or extra-ovarian metastasis, which have previously been designated as peritoneal strumosis, malignant SO, metastatic SO, or related terms... They designated this entity as “highly differentiated follicular carcinoma of ovarian origin (HDFCO). ” The diagnosis of HDFCO characteristically cannot be made until extra-ovarian dissemination is detected because of its non-neoplastic appearance... They also compared cases of HDFCO with those of typical thyroid-type carcinomas of ovarian origin with peritoneal involvement... They found that biological behavior is not different in the point that the prognosis seems to be favorable... In a study of 27 cases of biologically malignant SO with extraovarian dissemination or metastasis, Shaco-Levy et al. found that histologically malignant, adenomatous, or even normal primary tumors can show biologically malignant behavior... The authors found no independent factor to predict its biological behavior... Marti et al. suggested that pelvic surgery alone may be sufficient initial therapy for thyroid-type carcinoma confined to the ovary, whereas prophylactic total thyroidectomy with RAI may be reserved for patients with extraovarian spread or distant metastasis... In summary, we report a patient with a vertebral metastasis 10 years after diagnosis of histologically benign SO.

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(A) Sagittal magnetic resonance imaging showing an ill-defined lytic mass involving the thoracic 12 level. The mass destructs the vertebral body and spinal canal extending to the pedicle. (B, C) Needle biopsy of the spinal lesion reveals benign-looking thyroid follicles. (D) These cells are positive for thyroglobulin on immunohistochemical stain, supporting thyroid origin.
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f1-jptm-49-4-343: (A) Sagittal magnetic resonance imaging showing an ill-defined lytic mass involving the thoracic 12 level. The mass destructs the vertebral body and spinal canal extending to the pedicle. (B, C) Needle biopsy of the spinal lesion reveals benign-looking thyroid follicles. (D) These cells are positive for thyroglobulin on immunohistochemical stain, supporting thyroid origin.

Mentions: A 60-year-old woman presented with back pain. Magnetic resonance imaging revealed a destructive bone mass at the thoracic 12 level of the spine (Fig. 1A). Overall image analysis suggested a metastasis, but the origin could not be detected on a positron emission tomography–computed tomography (PET-CT) scan. Needle biopsy was performed on the spinal lesion, and microscopically it revealed thyroid follicles with colloids resembling normal thyroid tissue (Fig. 1B, C). Immunohistochemically, these cells were diffusely positive for thyroid transcription factor-1 and thyroglobulin (Fig. 1D), suggesting thyroid as origin of the tumor. Any evidence of nuclear atypia suspicious for papillary carcinoma was not detected throughout the lesion, which was consequently diagnosed as metastatic follicular carcinoma of thyroid.


Late Bone Metastasis of Histologically Bland Struma Ovarii: The Unpredictability of Its Biologic Behavior.

Oh SJ, Jung M, Kim YO - J Pathol Transl Med (2015)

(A) Sagittal magnetic resonance imaging showing an ill-defined lytic mass involving the thoracic 12 level. The mass destructs the vertebral body and spinal canal extending to the pedicle. (B, C) Needle biopsy of the spinal lesion reveals benign-looking thyroid follicles. (D) These cells are positive for thyroglobulin on immunohistochemical stain, supporting thyroid origin.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508574&req=5

f1-jptm-49-4-343: (A) Sagittal magnetic resonance imaging showing an ill-defined lytic mass involving the thoracic 12 level. The mass destructs the vertebral body and spinal canal extending to the pedicle. (B, C) Needle biopsy of the spinal lesion reveals benign-looking thyroid follicles. (D) These cells are positive for thyroglobulin on immunohistochemical stain, supporting thyroid origin.
Mentions: A 60-year-old woman presented with back pain. Magnetic resonance imaging revealed a destructive bone mass at the thoracic 12 level of the spine (Fig. 1A). Overall image analysis suggested a metastasis, but the origin could not be detected on a positron emission tomography–computed tomography (PET-CT) scan. Needle biopsy was performed on the spinal lesion, and microscopically it revealed thyroid follicles with colloids resembling normal thyroid tissue (Fig. 1B, C). Immunohistochemically, these cells were diffusely positive for thyroid transcription factor-1 and thyroglobulin (Fig. 1D), suggesting thyroid as origin of the tumor. Any evidence of nuclear atypia suspicious for papillary carcinoma was not detected throughout the lesion, which was consequently diagnosed as metastatic follicular carcinoma of thyroid.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Kosin University Gospel Hospital, Busan, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Struma ovarii (SO) is a subtype of ovarian teratoma that contains mostly thyroid tissue comprising more than 50% of the tumor volume... It is difficult to predict the metastatic potential of SO at initial diagnosis... Even SO that histologically resembles non-neoplastic thyroid tissue is sometimes associated with recurrence or extra-ovarian metastasis, which have previously been designated as peritoneal strumosis, malignant SO, metastatic SO, or related terms... They designated this entity as “highly differentiated follicular carcinoma of ovarian origin (HDFCO). ” The diagnosis of HDFCO characteristically cannot be made until extra-ovarian dissemination is detected because of its non-neoplastic appearance... They also compared cases of HDFCO with those of typical thyroid-type carcinomas of ovarian origin with peritoneal involvement... They found that biological behavior is not different in the point that the prognosis seems to be favorable... In a study of 27 cases of biologically malignant SO with extraovarian dissemination or metastasis, Shaco-Levy et al. found that histologically malignant, adenomatous, or even normal primary tumors can show biologically malignant behavior... The authors found no independent factor to predict its biological behavior... Marti et al. suggested that pelvic surgery alone may be sufficient initial therapy for thyroid-type carcinoma confined to the ovary, whereas prophylactic total thyroidectomy with RAI may be reserved for patients with extraovarian spread or distant metastasis... In summary, we report a patient with a vertebral metastasis 10 years after diagnosis of histologically benign SO.

No MeSH data available.


Related in: MedlinePlus