Wagner Christopher P, Hicks Brandi N, Nakamura Kevin M
Radiol Case Rep. 2015 Nov 6;6(3):478. doi: 10.2484/rcr.v6i3.478. eCollection 2011.
A postmenopausal female presented with an enlarging multinodular goiter. Microcalcifications within the largest thyroid nodule found by ultrasound prompted her to elect a total thyroidectomy. Histopathologic evaluation led to the diagnosis of confined papillary thyroid carcinoma (follicular variant). Elevated serum thyroglobulin levels were noted on postoperative laboratory workup, with the differential diagnosis of residual thyroid tissue, substernal extension of an adenomatoid multinodular goiter, and/or metastatic thyroid cancer. The patient then underwent thyrogen-stimulated I-131 ablation therapy, with postablation scans detecting a solitary focus of intensely increased radiotracer accumulation in the midline pelvis. Ultrasound of the pelvis revealed a corresponding right ovarian mass with mixed solid and cystic components. These combined findings were highly suggestive of struma ovarii. An exploratory laparotomy/bilateral salpingo-oophorectomy was performed, and pathologic examination confirmed a mature teratoma with predominant benign thyroid component consistent with struma ovarii.
一位绝经后女性因多结节性甲状腺肿增大前来就诊。超声检查发现最大的甲状腺结节内有微钙化，促使她选择了全甲状腺切除术。组织病理学评估确诊为局限型甲状腺乳头状癌（滤泡变体）。术后实验室检查发现血清甲状腺球蛋白水平升高，鉴别诊断包括残留甲状腺组织、腺瘤样多结节性甲状腺肿胸骨后延伸和/或甲状腺癌转移。随后患者接受了促甲状腺素刺激的碘-131消融治疗，消融后扫描发现在盆腔中线有一个放射性示踪剂摄取强烈增加的孤立灶。盆腔超声显示右侧卵巢有一个相应的混合实性和囊性成分的肿块。这些综合发现高度提示卵巢甲状腺肿。进行了剖腹探查术/双侧输卵管卵巢切除术，病理检查证实为成熟畸胎瘤，主要为良性甲状腺成分，符合卵巢甲状腺肿。
