Checrallah A, Medlej R, Saadé C, Khayat G, Halaby G
Department of Pathology, Hôtel Dieu Hospital, Beirut, Lebanon.
Thyroid. 2001 Sep;11(9):889-92. doi: 10.1089/105072501316973163.
Malignant struma ovarii is a rare disease; only a few cases are well documented in the literature. Thus, the overall prognosis and modalities of treatment are still somewhat controversial. In this article, the authors report a case of malignant struma ovarii discovered 4 years after ovariectomy after metastasis to the lungs and bones. Review of the pathology of the ovarian struma did not reveal the classic criteria of malignancy, there were, however, many features considered to be atypical and thus suspicious. The patient was treated by total thyroidectomy followed by repetitive doses of 131I. However, because of difficulties in increasing the level of endogenous thyrotropin (TSH) because of functional thyroid metastases in such an advanced disease, recombinant human thyrotropin (rhTSH; Thyrogen, thyrotropin alpha, Genzyme Corporation, Cambridge, MA) was used before administration of radioiodine. With this therapeutic protocol, the patient is still clinically stable 2 years after diagnosis.
恶性卵巢甲状腺肿是一种罕见疾病；文献中仅有少数病例有充分记录。因此，总体预后和治疗方式仍存在一定争议。在本文中，作者报告了一例卵巢切除术后4年发生肺和骨转移时发现的恶性卵巢甲状腺肿病例。对卵巢甲状腺肿的病理检查未发现典型的恶性标准，但有许多特征被认为是非典型的，因此具有可疑性。患者接受了全甲状腺切除术，随后多次给予131I治疗。然而，由于在这种晚期疾病中存在功能性甲状腺转移灶，难以提高内源性促甲状腺激素（TSH）水平，因此在给予放射性碘之前使用了重组人促甲状腺激素（rhTSH；Thyrogen，促甲状腺素α，Genzyme公司，马萨诸塞州剑桥）。采用这种治疗方案，患者在诊断后2年临床仍保持稳定。
