Stefanopol Ioana Anca, Petecariu Alexandru, Baroiu Liliana, Neagu Anca-Iulia, Bogdan-Goroftei Roxana-Elena, Nechifor Alexandru, Ciortea Diana-Andreea, Sarbu Nicolae
Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania.
Department of Pediatric Surgery, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania.
Children (Basel). 2023 May 11;10(5):856. doi: 10.3390/children10050856.
Struma ovarii (SO) is a monodermal teratoma containing at least 50% thyroid tissue. Classically, SO is a hormonally inactive benign neoplasm that occurs in premenopausal women, and has unspecific clinical and imaging features. Its treatment is surgical and its diagnosis is established histopathologically. We report the case of a euthyroid 16-year-old girl presenting with abdominal girth increase. An abdomino-pelvic ultrasound showed a giant multicystic mass with transonic content and multiple septa, and magnetic resonance imaging suggested the diagnosis of right ovarian mucinous cystadenoma. Blood tests showed inflammatory syndrome, iron deficiency anemia, mild hepatocytolysis, and elevated serum CA 125 levels. High-grade fever occurred on the third day of hospitalization, but none of the preoperative tests could identify its origin. Cystectomy was performed, and the histopathological examination revealed benign SO with a few small cysts with purulent content. The patient developed hypothyroidism postoperatively. In conclusion, this case report reunites most of the uncommon features of SO and confirms the superiorityof histopathology in its definitive diagnosis, as well as the suitability of ovarian sparing techniques, as the best treatment option for cystic ovarian pathology in pediatric patients, even in cases of large tumoral size and elevated serum CA 125 levels.
卵巢甲状腺肿（SO）是一种单胚层畸胎瘤，其中至少含有50%的甲状腺组织。经典的卵巢甲状腺肿是一种发生在绝经前女性的无激素活性的良性肿瘤，具有非特异性的临床和影像学特征。其治疗方法为手术治疗，诊断需依靠组织病理学检查。我们报告一例16岁甲状腺功能正常的女孩，因腹围增加前来就诊。腹部盆腔超声显示一个巨大的多囊性肿块，内含透声物质及多个分隔，磁共振成像提示诊断为右侧卵巢黏液性囊腺瘤。血液检查显示有炎症综合征、缺铁性贫血、轻度肝细胞溶解以及血清CA 125水平升高。住院第三天出现高热，但术前检查均未能明确其病因。遂行囊肿切除术，组织病理学检查显示为良性卵巢甲状腺肿，伴有一些含有脓性内容物的小囊肿。患者术后出现甲状腺功能减退。总之，本病例报告汇集了卵巢甲状腺肿的大多数罕见特征，证实了组织病理学在其明确诊断中的优越性，以及保留卵巢技术作为儿科患者囊性卵巢病变最佳治疗选择的适用性，即使在肿瘤体积较大且血清CA 125水平升高的情况下亦是如此。
