Shatila Mohamed, Ahmad Ijaz, Balega Janos, Kalkat Maninder S, Patel Akshay J
Department of Thoracic Surgery, University Hospitals Birmingham NHS Trust, UK; Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University Hospital, Alexandria, Egypt.
Department of Head and Neck Surgery, University Hospitals Birmingham NHS Trust, UK.
Int J Surg Case Rep. 2023 Dec;113:109080. doi: 10.1016/j.ijscr.2023.109080. Epub 2023 Nov 20.
Struma Ovarii is a rare type of monodermal teratoma with at least 50 % of its mass being thyroid tissue. They make up <1 % of all ovarian tumours and 3 to 5 % of all ovarian teratomas. These tumours are usually benign but malignant transformation is seen in <5 % of cases.
We present the case of a 45-year-old lady with three synchronous primary cancers on a background of Struma Ovarii; primary lung adenocarcinoma, papillary thyroid carcinoma and ovarian teratoma. Over the course of 18 months, this lady underwent full pelvic clearance of malignant Struma Ovarii and lymph nodes, total thyroidectomy, and an anatomical lung resection.
This case represents an incredibly rare condition of Struma Ovarii for which there is no firm management consensus. Furthermore, the uniqueness of three separate primaries has to the best of our knowledge not previously been reported in the literature.
This reinforces the notion that in select patients, radical management with curative intent is entirely possible but requires complete multi-disciplinary and multi-modal sub-specialty collaboration.
卵巢甲状腺肿是一种罕见的单胚层畸胎瘤，其至少50%的肿块为甲状腺组织。它们占所有卵巢肿瘤的比例不到1%，占所有卵巢畸胎瘤的3%至5%。这些肿瘤通常为良性，但不到5%的病例会发生恶性转化。
我们报告一例45岁女性，在卵巢甲状腺肿背景下同时患有三种原发性癌症；原发性肺腺癌、甲状腺乳头状癌和卵巢畸胎瘤。在18个月的病程中，该女性接受了恶性卵巢甲状腺肿及淋巴结的全盆腔清扫、甲状腺全切术和肺解剖性切除术。
该病例代表了一种极其罕见的卵巢甲状腺肿情况，对此尚无明确的治疗共识。此外，据我们所知，三种独立原发性癌症的独特情况此前在文献中尚未有报道。
这强化了这样一种观念，即在特定患者中，以治愈为目的的根治性治疗是完全可行的，但需要完整的多学科和多模式亚专业协作。
