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Malignant Struma Ovarii: Good Response after Thyroidectomy and 131I Ablation Therapy

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Author(s): Erica W.M. Janszen | Helena C. van Doorn | Patricia C. Ewing | Ronald R. de Krijger | Johannes H.W. de Wilt | Boen L.R. Kam | Wouter W. de Herder

Journal: Clinical Medicine : Oncology
ISSN 1177-9314

Volume: 2;
Start page: 147;
Date: 2008;
Original page

Keywords: malignant struma ovarii | radioiodine therapy | thyroidectomy | germ cell tumors | multidisciplinary approach

ABSTRACT
Background: Malignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature.Cases: We present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and ¹³¹I ablation therapy, two patients as fi rst line management, one following the occurrence of metastatic disease.Conclusion: Histological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine (¹³¹I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine (¹²³I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.
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