Department of Endocrinology and Metabolism, Section of Endocrinology, University of Pisa, Pisa, Italy.
Gynecol Endocrinol. 2012 Jan;28(1):39-42. doi: 10.3109/09513590.2011.579659. Epub 2011 May 24.
Ectopic thyroid tissue in ovarian teratoma or in struma ovarii appears to be histologically identical to the thyroid gland tissue and may virtually exhibit all the pathological patterns found in the thyroid gland. However, the concurrent lymphocytic infiltration of the thyroid gland, as found in Hashimoto's thyroiditis, and of the ectopic thyroid tissue is extremely rare. We describe the case of an 18-years old patient, in which a right ovarian 4 cm cyst has been found during pelvic ultrasound exam. The cyst was resected and microscopic examination of the mass revealed a mature cystic teratoma in which epidermal-like lining with skin adnexa, admixed with respiratory type epithelium, and areas of mature fatty, chondroid and dentigerous tissues were found. In a peripheral area of 0.7 cm × 0.5 cm, a prominent lymphocytic infiltrate surrounding thyroid follicles was identifiable. Thyroid function evaluation at different time points after surgery, revealed the development of mild hypothyroidism. Anti-TPO and anti-Tg autoantibodies were elevated, at fine needle aspiration biopsy a lymphocytic infiltrate, compatible with Hashimoto's thyroiditis, was present. We report here a rare case of Hashimoto's thyroiditis occurring both in the thyroid and in the ectopic thyroid tissue in the context of a benign cystic teratoma of the ovary.
卵巢畸胎瘤或卵巢甲状腺肿中的异位甲状腺组织在组织学上与甲状腺组织相同，实际上可能表现出甲状腺中发现的所有病理模式。然而，桥本甲状腺炎中同时存在的甲状腺浸润和异位甲状腺组织浸润极为罕见。我们描述了一位 18 岁患者的病例，在盆腔超声检查中发现右侧卵巢 4 厘米囊肿。切除了囊肿，对肿块的显微镜检查显示成熟囊性畸胎瘤，其中表皮样衬里伴皮肤附属物，混合有呼吸型上皮，以及成熟的脂肪、软骨和牙源性组织区域。在 0.7 厘米×0.5 厘米的周边区域，可识别出围绕甲状腺滤泡的明显淋巴细胞浸润。手术后不同时间点的甲状腺功能评估显示出轻度甲状腺功能减退的发展。抗 TPO 和抗 Tg 自身抗体升高，细针抽吸活检显示存在与桥本甲状腺炎一致的淋巴细胞浸润。我们在此报告一例罕见病例，即良性囊性卵巢畸胎瘤中同时发生桥本甲状腺炎，既发生在甲状腺，也发生在异位甲状腺组织中。
