A Case of Papillary Thyroid Carcinoma Arising from Struma Ovarii and Extending into the Bladder

Abstract

Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% -3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the most common type of malignant struma ovarii, followed by follicular carcinoma. Malignant struma ovarii is commonly seen in women in the fifth decade. The diagnosis is often made post-operatively after histological examination. Histology also helps assess tumor aggressiveness (mitoses, necrosis, poorly differentiated subtype, etc.). Given the rarity of these lesions, no therapeutic consensus or prognostic value had yet been formally established. We report herein, the case of a 76-year-old woman with a cystic tumor of the right ovary and a nodular lesion of the bladder. The clinical symptomatology is nonspecific, associating abdomino-pelvic pain and a right latero-uterine mass on abdominal palpation. After total hysterectomy with bilateral adnexectomy, the diagnosis of papillary carcinoma arising from struma ovarii and extending into the bladder was made. Through this observation, we suggest to discuss the anatomoclinical particularities of this rare pathological entity.

Papillary Carcinoma on Stroma Ovarii: A Case Report from Madagascar and Review of the Literature

“…Papillary carcinoma is the most common histological type of stromal ovarii malignancy, accounting for approximately 50% of malingant struma ovarii cases [11]. Immunohistochemical stains for thyroid transcription factor-1 (TTF-1) and thyroglobulin can help confirm the diagnosis [3]. For our patient, the immunohistochemical examination could not be carried out due to lack of financial resources.…”

“…Typical macroscopic examination shows a tumor with mixed solid and cystic components with mucosal or gelatinous content associated with mature teratoma components in the majority of cases. Histological diagnosis is based on the presence of ground glass nuclei, nuclear pseudo-inclusions and furrows seen on hematoxylin and eosin staining [3].…”

“…Ovarian struma, first reported by Bottlin in 1888 and later by Pick in 1902, is a rare monodermal variant of ovarian teratoma [2]. A malignant tumor on the ovarian struma is a rare tumor with one case reported in Madagascar [3]. The management strategy is based on whether ovarian surgery is associated or not with radioactive iodine [4].…”