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El struma ovarii es un tumor bastante inusual, hallado en el 2,7 % de los teratomas de ovario. Su variedad quística es bastante rara, siendo su diagnóstico diferencial un cistoadenoma de ovario. Se caracteriza por presentar zona sólida con folículos tiroideos con coloide en su interior, y una zona quística tapizada por un epitelio plano a cuboidal, ambos con marcación para TTF1. Presentamos el caso clínico de una paciente que fue remitida a nuestro hospital por presentar una masa a la palpación vaginal. En imágenes se observa la presencia de una masa anexial derecha quística, por lo cual se le realizó una histerectomía radical con salpingooferectomía bilateral. Luego de estudios de patología y de inmunohistoquímica, se llegó a la conclusión que correspondía a un struma ovarii quístico

Struma ovarii is a rather unusual tumor, found in 2.7% of ovarian teratomas. Its cystic variety is quite rare, with its differential diagnosis being an ovarian cystadenoma. It is characterized by the presence of a solid area with thyroid follicles with colloid inside, and a cystic area lined by a flat to cuboidal epithelium, both with TTF1 marking. We describe the case report of a patient referred to our hospital for presenting a mass on vaginal examination. Imaging studies revealed the presence of a right adnexal cystic mass, for which she underwent a radical hysterectomy with bilateral salpingo-oophorectomy. After pathology and immunohistochemistry studies, it was concluded that it corresponded to a cystic struma ovarii

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Struma ovarii is a rare type of ovarian tumor composed of more than 50% of thyroid tissue. It represents only 1% of solid ovarian tumors and 3% of dermoid subtypes, with the majority of cases following a benign course. It typically affects women between the third and fifth decades of life and often remains asymptomatic or presents with nonspecific signs. pseudo-Meigs syndrome, characterized by ascites and pleural effusion, may be present, complicating the diagnosis. Case report: A 43-year-old woman presented with abdominal discomfort, pelvic pain, and chronic dyspnea. A CT scan identified a solid-cystic pelvic mass, moderate ascites, and right-sided pleural effusion. Magnetic resonance imaging (MRI) confirmed the findings, raising suspicion of malignant ovarian tumor. The serum tumor marker CA-125 was elevated. The patient underwent exploratory laparotomy, resulting in bilateral salpingo-oophorectomy. Histopathological analysis of the specimen confirmed the diagnosis of struma ovarii in the left ovary and mature cystic teratoma in the right ovary. Conclusion: Elevated CA-125 levels can be found in cases of struma ovarii, posing a differential diagnosis challenge with malignant ovarian neoplasms, especially when associated with pseudo-Meigs syndrome. Therefore, although rare, it should be considered as a possibility during clinical investigation of ovarian masses with atypical presentations. Imaging studies can assist, but confirmation is established through microscopic analysis. Treatment involves simple surgical resection, and symptom disappearance follows, with favorable prognosis

Struma ovarii é um tipo raro de tumor ovariano composto por mais de 50% de tecido tireoidiano. Representa apenas 1% dos tumores sólidos do ovário e 3% dos subtipos dermoides, com a maioria dos casos de curso benigno. Geralmente afeta mulheres entre a terceira e a quinta décadas de vida, sendo muitas vezes assintomático ou com sinais inespecíficos. A síndrome de pseudo-Meigs, caracterizada por ascite e derrame pleural, pode estar presente, dificultando o diagnóstico. Relato do caso: Mulher, 43 anos, com desconforto abdominal, dor pélvica e dispneia crônica. A tomografia identificou massa sólido-cística na pelve e ascite moderada, além de derrame pleural à direita. A ressonância magnética confirmou as alterações e, desse modo, suspeitou-se de tumor maligno ovariano. O marcador sérico tumoral CA-125 estava elevado. A paciente foi submetida a uma laparotomia exploradora que resultou em salpingo-oforectomia bilateral. A análise histopatológica do espécime confirmou o diagnóstico de struma ovarii em ovário esquerdo e teratoma cístico maduro à direita. Conclusão: Os níveis elevados de CA-125 podem ser encontrados em casos de struma ovarii, tornando-o diagnóstico diferencial nas neoplasias ovarianas malignas, especialmente quando associado à síndrome de pseudo-Meigs. Nesse sentido, embora raro, o tumor deve ser considerado uma possibilidade durante investigação clínica de massas ovarianas com apresentações atípicas. Os exames de imagem podem auxiliar, mas a confirmação é estabelecida pela análise microscópica. O tratamento consiste na ressecção cirúrgica simples, e o desaparecimento dos sintomas acontece em seguida, sendo de bom prognóstico.

El struma ovarii es un tipo raro de tumor ovárico compuesto por más del 50% de tejido tiroideo. Representa solo el 1% de los tumores ováricos sólidos y el 3% de los subtipos dermoides, siendo en su mayoría benigno. Típicamente afecta a mujeres entre la tercera y quinta década de vida y a menudo permanece asintomático o presenta signos inespecíficos. El síndrome de pseudo-Meigs, caracterizado por ascitis y derrame pleural, puede estar presente, complicando el diagnóstico. Informe del caso: Una mujer de 43 años consultó por malestar abdominal, dolor pélvico y disnea crónica. La tomografía identificó una masa pélvica sólido-quística, ascitis moderada y derrame pleural en el lado derecho. La resonancia magnética confirmó los hallazgos, levantando sospechas de un tumor ovárico maligno. El marcador tumoral sérico CA-125 estaba elevado. La paciente fue sometida a una laparotomía exploratoria, resultando en salpingo-ooforectomía bilateral. El análisis histopatológico de la muestra confirmó el diagnóstico de struma ovarii en el ovario izquierdo y teratoma quístico maduro en el ovario derecho. Conclusión: Los niveles elevados de CA-125 pueden encontrarse en casos de struma ovarii, lo que lo convierte en diagnóstico diferencial con neoplasias ováricas malignas, especialmente cuando se asocia con el síndrome de pseudo-Meigs. Por lo tanto, aunque sea raro, se debe considerar como una posibilidad durante la investigación clínica de masas ováricas con presentaciones atípicas. Los estudios por imágenes pueden ayudar, pero la confirmación se establece mediante análisis microscópico. El tratamiento implica la resección quirúrgica simple y los síntomas desaparecen después, con un pronóstico favorable.

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Introdução: Struma ovarii é um tipo raro de tumor ovariano composto por mais de 50% de tecido tireoidiano. Representa apenas 1% dos tumores sólidos do ovário e 3% dos subtipos dermoides, com a maioria dos casos de curso benigno. Geralmente afeta mulheres entre a terceira e a quinta décadas de vida, sendo muitas vezes assintomático ou com sinais inespecíficos. A síndrome de pseudo-Meigs, caracterizada por ascite e derrame pleural, pode estar presente, dificultando o diagnóstico. Relato do caso: Mulher, 43 anos, com desconforto abdominal, dor pélvica e dispneia crônica. A tomografia identificou massa sólido-cística na pelve e ascite moderada, além de derrame pleural à direita. A ressonância magnética confirmou as alterações e, desse modo, suspeitou-se de tumor maligno ovariano. O marcador sérico tumoral CA-125 estava elevado. A paciente foi submetida a uma laparotomia exploradora que resultou em salpingo-oforectomia bilateral. A análise histopatológica do espécime confirmou o diagnóstico de struma ovarii em ovário esquerdo e teratoma cístico maduro à direita. Conclusão: Os níveis elevados de CA-125 podem ser encontrados em casos de struma ovarii, tornando-o diagnóstico diferencial nas neoplasias ovarianas malignas, especialmente quando associado à síndrome de pseudo-Meigs. Nesse sentido, embora raro, o tumor deve ser considerado uma possibilidade durante investigação clínica de massas ovarianas com apresentações atípicas. Os exames de imagem podem auxiliar, mas a confirmação é estabelecida pela análise microscópica. O tratamento consiste na ressecção cirúrgica simples, e o desaparecimento dos sintomas acontece em seguida, sendo de bom prognóstico

Introduction: Struma ovarii is a rare type of ovarian tumor composed of more than 50% of thyroid tissue. It represents only 1% of solid ovarian tumors and 3% of dermoid subtypes, with the majority of cases following a benign course. It typically affects women between the third and fifth decades of life and often remains asymptomatic or presents with nonspecific signs. pseudo-Meigs syndrome, characterized by ascites and pleural effusion, may be present, complicating the diagnosis. Case report: A 43-year-old woman presented with abdominal discomfort, pelvic pain, and chronic dyspnea. A CT scan identified a solid-cystic pelvic mass, moderate ascites, and right-sided pleural effusion. Magnetic resonance imaging (MRI) confirmed the findings, raising suspicion of malignant ovarian tumor. The serum tumor marker CA-125 was elevated. The patient underwent exploratory laparotomy, resulting in bilateral salpingo-oophorectomy. Histopathological analysis of the specimen confirmed the diagnosis of struma ovarii in the left ovary and mature cystic teratoma in the right ovary. Conclusion: Elevated CA-125 levels can be found in cases of struma ovarii, posing a differential diagnosis challenge with malignant ovarian neoplasms, especially when associated with pseudo-Meigs syndrome. Therefore, although rare, it should be considered as a possibility during clinical investigation of ovarian masses with atypical presentations. Imaging studies can assist, but confirmation is established through microscopic analysis. Treatment involves simple surgical resection, and symptom disappearance follows, with favorable prognosis.

Introducción: El struma ovarii es un tipo raro de tumor ovárico compuesto por más del 50% de tejido tiroideo. Representa solo el 1% de los tumores ováricos sólidos y el 3% de los subtipos dermoides, siendo en su mayoría benigno. Típicamente afecta a mujeres entre la tercera y quinta década de vida y a menudo permanece asintomático o presenta signos inespecíficos. El síndrome de pseudo-Meigs, caracterizado por ascitis y derrame pleural, puede estar presente, complicando el diagnóstico. Informe del caso: Una mujer de 43 años consultó por malestar abdominal, dolor pélvico y disnea crónica. La tomografía identificó una masa pélvica sólido-quística, ascitis moderada y derrame pleural en el lado derecho. La resonancia magnética confirmó los hallazgos, levantando sospechas de un tumor ovárico maligno. El marcador tumoral sérico CA-125 estaba elevado. La paciente fue sometida a una laparotomía exploratoria, resultando en salpingo-ooforectomía bilateral. El análisis histopatológico de la muestra confirmó el diagnóstico de struma ovarii en el ovario izquierdo y teratoma quístico maduro en el ovario derecho. Conclusión: Los niveles elevados de CA-125 pueden encontrarse en casos de struma ovarii, lo que lo convierte en diagnóstico diferencial con neoplasias ováricas malignas, especialmente cuando se asocia con el síndrome de pseudo-Meigs. Por lo tanto, aunque sea raro, se debe considerar como una posibilidad durante la investigación clínica de masas ováricas con presentaciones atípicas. Los estudios por imágenes pueden ayudar, pero la confirmación se establece mediante análisis microscópico. El tratamiento implica la resección quirúrgica simple y los síntomas desaparecen después, con un pronóstico favorable.

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El hipertiroidismo se define como la producción excesiva de hormonas tiroideas a partir de tejido tiroideo maduro eutópico o ectópico. La prevalencia general de hipertiroidismo es 1.2%, y la causa más frecuente es la enfermedad de Graves. El estruma ovárico representa el 1% de todos los tumores ováricos y es una causa infrecuente de hipertiroidismo ectópico. Su comportamiento es benigno en más del 90% de los casos; usualmente asintomáticos, sólo el 8% se presentan con tirotoxicosis, y es infrecuente su asociación con enfermedad de Graves. Se comunica el caso de una paciente con esta infrecuente asociación.

Hyperthyroidism is defined as an excessive production of thyroid hormones by eutopic or ectopic mature thyroid tissue. The overall prevalence of hyperthyroidism is 1.2% and the most common cause is Graves' disease. Struma ovarii represents 1% of all ovarian tumors and is an uncommon cause of ectopic hyperthyroidism. It is benign in >90% of the cases; usually asymptomatic, and only 8% are presented with thyrotoxicosis, being rare its association with Graves' disease. We report the case of a patient with this association.

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Hyperthyroidism is defined as an excessive production of thyroid hormones by eutopic or ectopic mature thyroid tissue. The overall prevalence of hyperthyroidism is 1.2% and the most common cause is Graves' disease. Struma ovarii represents 1% of all ovarian tumors and is an uncommon cause of ectopic hyperthyroidism. It is benign in >90% of the cases; usually asymptomatic, and only 8% are presented with thyrotoxicosis, being rare its association with Graves' disease. We report the case of a patient with this association.

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CASE: We report the case of a 38-year-old woman who presented with a lytic bone lesion in the left scapula. A biopsy showed a tumor with the histologic appearance of thyroid tissue. She also was found to have a thyroid nodule and an enlarged ovary, both of which were excised. The thyroid nodule turned out to be a benign colloid nodule, and the ovary contained a monodermal teratoma composed of thyroid tissue (struma ovarii). The lesion in the scapula eventually was proven to be metastatic malignant struma ovarii. CONCLUSION: Malignant struma ovarii with bone metastases is very rare, and its diagnosis is a challenge. There are some documented cases with bone metastases, mostly to the thoracic and lumbar spine. The optimal treatment of choice for the bone lesion is unknown because of the rarity of its presentation.

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Introducción: 20 por ciento de los tumores ováricos son de células germinales; y, aunque muchos no pueden ser clasificados por citología, los teratomas sí, y entre estos, el estruma formado por tejido tiroideo. Reconocerlo, ayuda al patólogo en el manejo de la biopsia intraoperatoria y define el proceder clínico quirúrgico. Presentación del caso: mujer de 29 años atendida en urgencias por dolor en región inguinal derecha. Al examinarla se constató tumoración de alrededor de 8 cm en región pélvica derecha, dolorosa al palparla. En el tacto vaginal se percibió masa tumoral gonadal de consistencia firme. El ultrasonido arrojó en el ovario derecho una imagen ecolúcida de paredes gruesas con imágenes hipoecogénicas en su interior, con bordes irregulares de 67 x 97 mm, e imagen ecogénica que ocupa el 20 % de la lesión, con pobre patrón vascular. Conclusiones: los datos clínicos, y los exámenes imagenológicos y citológicos, permiten diagnosticar un estruma ovárico benigno(AU)

Introduction: twenty percent of ovarian tumors are of germinal cells and although many cannot be classified through cytology, teratomes can, and among them, the struma formed by the thyroid tissue. Recognizing this fact helps the pathologist to manage intraoperative biopsy and to define the surgical clinical procedure. Case presentation: a 29 years-old woman seen in the emergency service to relieve pain in her right inguinal region. On the physical exam, an 8 cm tumor was found in the right pelvic region, causing pain when palpating it. The vaginal exam revealed solid gonadal tumor mass. The ultrasound test showed in the right overy an echolucent image of thick walls with hypoechogenic images inside with 67 x 97 mm irregular contours and echogenic image covering 20 percent of lesion, with poor vascular pattern. Conclusions: clinical data and imaging and cytological exams allow diagnosing benign struma ovarii(AU)

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The Malignant Struma ovarii (SO) is a thyroid carcinoma generated in a mature teratoma, constitutes 0.8-3percent of ovarian tumors. Then, two cases will be reviewed. Case 1: 46 year old woman with no known morbid consulted for right iliac fossa pain requiring exploratory laparotomy with findings of an ovarian tumor, the biopsy reported mature ovarian teratoma SO type microfocus papillary thyroid carcinoma. Case 2: 59 year old female with a history of dyslipidemia and knee osteoarthritis in controls in gynecology since 2010 on the right adnexal mass of cystic type of 5x3 cm. The study showed only free fluid dissemination ovarian, oofectomía bilateral was performed and biopsy showed minimally invasive follicular carcinoma (2.8 cm) developed by SO, serosa without invasion of the ovary. Is derived of endocrinology and the study showed: thyroid stimulating hormone (TSH) 3.3 uIU/ ml; Peroxidase antibody (anti-TPO) and thyroglobulin antibody (antiTG) negative. Ultrasonography exhibited thyroid nodule of 0.8 x 0.6 cm, hipovascularizado with normal thyroid cintigraphy and cytology negative for neoplastic cells in fine needle aspiration (FNA). Discussion: It’s a rare condition, which requires a multidisciplinary approach to treatment...

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Objetivo: presentar un caso de teratoma especializado del ovario y hacer una revisión de la literatura publicada en relación con la epidemiología y las características diagnósticas con énfasis en el diagnóstico histopatológico.Materiales y métodos: se presenta el caso de una paciente de 50 años de edad, con masa pélvica, que consulta a la ESE Clínica Maternidad Rafael Calvo, centro de referencia del departamento de Bolívar, institución de segundo nivel de complejidad, que atiende a pacientes de estratos socioeconómicos bajos y población rural. La ecografía y la tomografía axial computarizada muestran teratoma ovárico bilateral. Se realizó histerectomía más salpingooferectomía bilateral. El examen histopatológico del tumor derecho mostró múltiples estructuras foliculares tiroideas, con contenido coloide; se diagnostica struma ovarii. Se realizó una búsqueda de la literatura en Medline vía PubMed de 1966 a la fecha; además se buscó en Hinari, Imbiomed y Ebsco usando los términos: “Struma Ovarii”, “Ovario”, “Estruma”, “Teratoma monodérmico”, “Teratoma bilateral”, publicados en inglés o español que trataran sobre la epidemiología y el diagnóstico histopatológico.Resultados: se encontraron 450 artículos publicados, de los cuales se revisó un total de 27 relacionados con struma ovarii y teratomas bilaterales, de estos se seleccionaron 11 que correspondieron a reportes de casos y revisiones de tema.Conclusiones: el struma ovarii es una variante especializada de los teratomas ováricos, los signos y síntomas de hipertiroidismo y la aparición asociada de masa pélvica pueden sugerir el diagnóstico. El ultrasonido y la tomografía axial pueden ser útiles en el diagnóstico diferencial. Los criterios histopatológicos juegan un papel crucial en el diagnóstico definitivo.

Objective: To present a case of specialized ovarian teratoma and a review of the published literature on the epidemiology and the diagnostic characteristics of this tumor, emphasizing the histopathological diagnosis.Materials and methods: A 50 year-old female patient who was seen because a pelvic mass at the ESE Clínica Maternidad Rafael Calvo, level II referral center in the Department of Bolívar that serves patients of the rural areas and low socioeconomic levels. Ultrasound and computerized axial tomography revealed bilateral ovarian teratomas. Hysterectomy plus bilateral salpyngo-oophorectomy was performed. The histopathology of the right-sided tumor showed multiple follicular thyroid structures with colloid content, resulting in a diagnosis of Struma Ovarii. A search of the literature was conducted in Medline via Pubmend, from 1996 to this date. Additional searches were conducted in Hinari, Imbiomed, and Ebsco using the terms “Struma Ovarii”, “Ovary”, “Struma”, “Monodermal teratoma”, “Bilateral teratoma”, published in English or Spanish and dealing with the epidemiology and the histopathological diagnosis.Results: Overall, 450 published articles were found and, of those, 27 relating to struma ovarii and bilateral teratomas were reviewed. Of those, 11 case reports and reviews of the subject were selected.Conclusions: Struma ovarii is a specialized variant of ovarian teratomas, and signs and symptoms such as hyperthyroidism and the associated presence of a pelvic mass may suggest the diagnosis. Diagnostic tests include ultrasound and axial tomography, which may help with differentiation and diagnosis. Histopathological criteria play a crucial role in the final diagnosis. Histopathological criteria play a crucial role in the final diagnosis.

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A 38-year-old woman with metastatic malignant struma ovarii, including massive liver metastases and retroperitoneal lymphadenopathy, underwent ovarian resection and retroperitoneal lymph nodes excision, partial hepatectomy, and radiofrequency ablation for liver metastases. She underwent thyroidectomy and received three I treatments using recombinant human thyrotropin stimulation and radioiodine dosimetry. posttherapy I imaging, anatomic images, and thyroglobulin levels showed significant diminution in the tumor burdens and remarkable decline in thyroglobulin levels. This case provided valuable information on recombinant human thyrotropin-assisted I ablation in conjunction with dosimetry in an unusual presentation of iodine-avid malignant struma ovarii with bulky metastases.

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A 41-year-old woman presented with multiple right lower quadrant masses which were removed and consistent with metastatic follicular thyroid cancer. Thyroidectomy revealed no primary malignancy and evaluation of her ovaries was positive for struma ovarii. The patient was diagnosed with metastatic struma ovarii stage IV. Nine days following the patient's second therapy with I for recurrent disease, planar and SPECT/CT imaging demonstrated multiple I avid peritoneal nodules. At least one of them, located along the medial margin of the spleen, would have been difficult to diagnose without hybrid SPECT/CT imaging.

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Struma ovarii is an ovarian teratoma composed mainly of thyroid tissue, which can occasionally develop a malignant thyroid tumor. We report a 61 years old female consulting for a metrorrhagia in whom an ovarian cyst was discovered. The patient was subjected to a hysterectomy and bilateral oophorectomy. The pathological study of the surgical piece revealed a focus of papillary thyroid carcinoma, follicular variety in a right struma ovarii. Three months after surgery, an abdominal CAT scan did not show any abnormality.

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A 41-year old woman post thyroidectomy and neck dissection is presented in this case. She initially presented goiter and an enlarged cervical lymph node. She had no family history of cancer or radiation therapy. She had total thyroidectomy and found to have papillary thyroid cancer (T4N1M0). Histopathology report revealed multifocal classical papillary thyroid carcinoma with lympho-vascular invasion, extra-thyroidal extension, and positive lymph nodes. She was treated with 6.5 Gigabecquerel (GBq) of 131Iodine. Whole-body scan showed uptake in the neck and large focus in the left lower abdomen. Single-photon emission computed tomography SPECT/CT demonstrated a round shaped mass in the left pelvis. Pathology revealed cystic teratoma with benign thyroid tissue (struma ovarii), and no malignancy. Two months later, she had the second treatment with 5.5 GBq 131Iodine. Her follow-up stimulated and non-stimulated thyroglobulin levels were significantly lower, and there was no abnormal uptake in the follow-up scan.

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Objetivo: se presenta un caso de estrumosis peritoneal para hacer una revisión de la literatura publicada acerca de las características histológicas y clínicas de estos tumores. Presentación del caso: paciente de 48 años de edad con historia de ooforectomía izquierda hace 34 años por tumor ovárico benigno, consulta al Hospital Universitario del Caribe, centro de referencia del departamento de Bolívar, por presentar dolor en hipocondrio izquierdo. Examen físico: masa abdominal confirmada mediante ultrasonido y tomografía computarizada abdominal. Se encontró masa retroperitoneal de 15,5 x 10,5 x 7 cm, en la laparotomía exploratoria, la cual se resecó. El análisis microscópico reveló tejido tiroideo constituido por folículos con estructura típica, lo cual indicó una estrumosis peritoneal. Materiales y métodos: se realizó una revisión bibliográfica en cinco bases de datos (Medline, Ebsco, PubMed, Science Direct y Cochrane Reviews), utilizando como encabezados de búsqueda [Título/Resumen]: peritoneal struma, peritoneal strumosis, struma ovarii. Se incluyeron 15 citas bibliográficas. Conclusiones: la estrumosis peritoneal es una lesión poco frecuente, asociada al teratoma quístico maduro del ovario, cuyo diagnóstico preoperatorio es difícil. Este es un nuevo caso publicado en la literatura mundial...

Objective: a case of peritoneal strumosis is presented for making a review of the literature published about these histological tumors and their clinical characteristics. Case presentation: a 48-year-old patient, having a history of left side oophorectomy 34 beforehand due to a benign ovarian tumor, consulted at the Caribe Teaching Hospital (a reference centre for the Bolívar department) as she had pain in the left hypochondrium. Physical exam: abdominal mass confirmed by ultrasound and abdominal computerized tomography. A 15.5 x 10.5 x 7 cm retroperitoneal mass was found during exploratory laparotomy which was removed. Microscope analysis revealed thyroid tissue consisting of follicles having typical structure, constituting a peritoneal strumosis. Materials and methods: a literature review was made of five databases (Medline, Emsco, PubMed, Science Direct and Cochrane Reviews), using search keywords [Title/Summary]: “peritoneal struma”, “peritoneal strumosis” ad “struma ovarii”; 15 bibliographical citations were included. Conclusions: peritoneal strumosis is an infrequently occurring lesion which is associated with mature cystic teratoma of the ovary, whose pre-operation diagnosis is difficult. This is a new case published in the worldwide literature...

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A 41-year old woman post thyroidectomy and neck dissection is presented in this case. She initially presented goiter and an enlarged cervical lymph node. She had no family history of cancer or radiation therapy. She had total thyroidectomy and found to have papillary thyroid cancer (T4N1M0). Histopathology report revealed multifocal classical papillary thyroid carcinoma with lympho-vascular invasion, extra-thyroidal extension, and positive lymph nodes. She was treated with 6.5 Gigabecquerel (GBq) of 131Iodine. Whole-body scan showed uptake in the neck and large focus in the left lower abdomen. Single-photon emission computed tomography SPECT/CT demonstrated a round shaped mass in the left pelvis. Pathology revealed cystic teratoma with benign thyroid tissue (struma ovarii), and no malignancy. Two months later, she had the second treatment with 5.5 GBq 131Iodine. Her follow-up stimulated and non-stimulated thyroglobulin levels were significantly lower, and there was no abnormal uptake in the follow-up scan.

Este é o caso de uma mulher de 41 anos de idade, com pós-tireoidectomia e dissecção da área do pescoço. Ela inicialmente apresentou bócio e um linfonodo cervical aumentado. Não tinha histórico familiar de câncer ou tratamento com radiação. Ela foi submetida a uma tiroidectomia total e se observou um carcinoma papilar de tiroide (T4N1M0). Os achados histopatológicos revelaram carcinoma papilar multifocal clássico com invasão linfovascular, extensão extratiroideana e linfonodos positivos. Ela foi tratada com 6.5 Gigabecquerel (GBq) de Iodo131. A tomografia de corpo inteiro mostrou captação na área do pescoço e um grande foco no abdômen inferior esquerdo. A tomografia computadorizada por emissão de fóton único SPECT/CT demonstrou uma massa arredondada na pelve esquerda. A análise patológica revelou um teratoma cístico com tecido tiroideano benigno (struma ovarii) e nenhuma malignidade. Dois meses depois, ela foi submetida a um segundo tratamento com 5.5 GBq de Iodo131. O acompanhamento dos níveis de tireoglobulina estimulada e não estimulada foi significativamente mais baixo e não houve captação anormal na tomografia seguinte.

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Este relato de caso trata de uma paciente com hipotireoidismo, que apresentou tumor ovariano raro, de tecido tireoidiano, denominado Struma ovarii. Em análise da literatura, somente 5% dos casos associa-se a hipertireoidismo, não havendo relatos de associação a hipotireoidismo. Foram demonstradas imagens de ultrassonografia, laparoscopia e histologia do tumor, e realizadas comparações clínicas com as características previamente descritas sobre esse tipo de tumor

This case report is about a patient with hypothyroidism who presented a rare ovarian tumor containing thyroid tissue, known as struma ovarii. According to the literature, only 5% of the cases are associated with hyperthyroidism and there are no reports of an association with hypothyroidism. Ultrasound, laparoscopic and histological images of the tumor were compared with the characteristics of this type of tumor described in the literature

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El cáncer de ovario representa uno de los grandes desafíos aún no resueltos de la ginecología oncológica. Requiere de un enfoque multidisciplinario con cirugía, cuyo objetivo es la cito reducción óptima, lo que demanda un gran esfuerzo quirúrgico, debiendo complementarse en la mayoría de los casos con poli quimioterapia. Lamentablemente la enfermedad se manifiesta por lo común en etapas avanzadas y tiene altas tasas de persistencia y recurrencia. Se presentan aquí las características más importantes de esta enfermedad así como su manejo actual y resultados.

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Los teratomas de ovario son los blastomas ováricos más frecuentes en la etapa infanto-juvenil en la mujer: derivados de las células germinales totipotenciales pueden contener tejidos del ectodermo,mesodermo y endodermo. El estruma ovárico es un teratoma con predominio de tejido tiroideo. Son excepcionales en la etapa infanto-juvenil. Existen estrumas benignos y malignos y se presentan con una frecuencia de 2 por ciento y 0,3 por ciento respectivamente dentro de la frecuencia total de los teratomas. Asintomáticos en su mayoría, pueden manifestarse como tumor abdominopélvico y producir ascitis e hidrotórax.Se presenta un caso de estruma ovárico benigno en una adolescente de 15 años, que consultó por tumor abdominal de crecimiento lento, lo que motivó rechazo social en su medio escolar por presunción de embarazo.

Assuntos

RESUMO

Los teratomas de ovario son los blastomas ováricos más frecuentes en la etapa infanto-juvenil en la mujer: derivados de las células germinales totipotenciales pueden contener tejidos del ectodermo,mesodermo y endodermo. El estruma ovárico es un teratoma con predominio de tejido tiroideo. Son excepcionales en la etapa infanto-juvenil. Existen estrumas benignos y malignos y se presentan con una frecuencia de 2 por ciento y 0,3 por ciento respectivamente dentro de la frecuencia total de los teratomas. Asintomáticos en su mayoría, pueden manifestarse como tumor abdominopélvico y producir ascitis e hidrotórax.Se presenta un caso de estruma ovárico benigno en una adolescente de 15 años, que consultó por tumor abdominal de crecimiento lento, lo que motivó rechazo social en su medio escolar por presunción de embarazo. (AU)

Assuntos