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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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Histological features of struma ovarii. Most of the tumor consist of dilated follicles reminiscent of nodular goiter (A) while a small part of the tumor shows densely packed microfollicles (B) with mild nuclear irregularity, overlapping, and vague clearing (C).
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f2-jptm-49-4-343: Histological features of struma ovarii. Most of the tumor consist of dilated follicles reminiscent of nodular goiter (A) while a small part of the tumor shows densely packed microfollicles (B) with mild nuclear irregularity, overlapping, and vague clearing (C).

Mentions: Upon review of the pathology report and slides, the ovarian cyst was a 12-cm-sized multilocular mass with a smooth outer surface. Microscopic examination showed benign looking thyroid tissue characterized by round follicles, most of which were dilated, but some follicles were small and others were medium sized. Many follicles contained intraluminal colloids, and they were lined by cuboidal epithelial cells with moderate amounts of cytoplasm (Fig. 2A). However, a complete examination revealed a focus of 0.5-cm-sized closely packed microfollicles with nuclear irregularity, overlapping, and vague clearing (Fig. 2B, C). These features resembled a follicular variant of papillary carcinoma (FVPC), but were insufficient to establish a definite diagnosis of FVPC. Other characteristics suspicious for malignancy such as vascular or ovarian capsular invasion were not noted. No other teratomatous components were identified. A possibility of unusual metastasis from SO was suggested for the spinal lesion.


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)

Histological features of struma ovarii. Most of the tumor consist of dilated follicles reminiscent of nodular goiter (A) while a small part of the tumor shows densely packed microfollicles (B) with mild nuclear irregularity, overlapping, and vague clearing (C).
© Copyright Policy
Related In: Results  -  Collection

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

f2-jptm-49-4-343: Histological features of struma ovarii. Most of the tumor consist of dilated follicles reminiscent of nodular goiter (A) while a small part of the tumor shows densely packed microfollicles (B) with mild nuclear irregularity, overlapping, and vague clearing (C).
Mentions: Upon review of the pathology report and slides, the ovarian cyst was a 12-cm-sized multilocular mass with a smooth outer surface. Microscopic examination showed benign looking thyroid tissue characterized by round follicles, most of which were dilated, but some follicles were small and others were medium sized. Many follicles contained intraluminal colloids, and they were lined by cuboidal epithelial cells with moderate amounts of cytoplasm (Fig. 2A). However, a complete examination revealed a focus of 0.5-cm-sized closely packed microfollicles with nuclear irregularity, overlapping, and vague clearing (Fig. 2B, C). These features resembled a follicular variant of papillary carcinoma (FVPC), but were insufficient to establish a definite diagnosis of FVPC. Other characteristics suspicious for malignancy such as vascular or ovarian capsular invasion were not noted. No other teratomatous components were identified. A possibility of unusual metastasis from SO was suggested for the spinal lesion.

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