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Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread.

Publication ,  Journal Article
Robboy, SJ; Shaco-Levy, R; Peng, RY; Snyder, MJ; Donahue, J; Bentley, RC; Bean, S; Krigman, HR; Roth, LM; Young, RH
Published in: Int J Gynecol Pathol
September 2009

Struma ovarii that display extraovarian spread or later recurrence is exceedingly rare. Among 88 patients with "malignant" struma ovarii followed for prolonged periods, several features helped to predict the adverse clinical course. Adhesions (graded 2 to 4+), peritoneal fluid (> or =1 L) or ovarian serosal rent were worrisome features, occurring in 74% of 27 biologically malignant tumors but only 10% of 61 clinically benign tumors. The size of the strumal component rather than the overall size of the ovarian teratoma also had some predictive value. Tumors with a strumal component < or =6 cm recurred rarely (7%), whereas 33% of the consult and 88% of the literature cases > or =12 cm were clinically malignant. Except for a papillary pattern or poorly differentiated cancer, no microscopic feature reliably predicted the clinical outcome, including those typically associated with malignancy in primary thyroid tumors. Among the consult cases, 7% with histologic follicular adenomas and 29% with papillary carcinomas were clinically malignant. Unequivocal vascular invasion was rare, precluding assessment of its effect. Optically clear nuclei, when extensive, were useful to diagnose papillary carcinoma, but were present nevertheless in smaller numbers in both macrofollicular and microfollicular adenomas. Eight tumors confined initially to the ovary (stage 1) recurred. Papillary carcinomas recurred earlier (average 4 y) than follicular adenomatous neoplasms (average 11 y, range: 1-29 y). Overall, the survival rate for all patients was 89% at 10 years and 84% at 25 years, indicating the need for routine long-term follow-up.

Duke Scholars

Published In

Int J Gynecol Pathol

DOI

EISSN

1538-7151

Publication Date

September 2009

Volume

28

Issue

5

Start / End Page

405 / 422

Location

United States

Related Subject Headings

  • Young Adult
  • Struma Ovarii
  • Risk Factors
  • Pathology
  • Ovarian Neoplasms
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Kaplan-Meier Estimate
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Robboy, S. J., Shaco-Levy, R., Peng, R. Y., Snyder, M. J., Donahue, J., Bentley, R. C., … Young, R. H. (2009). Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol, 28(5), 405–422. https://doi.org/10.1097/PGP.0b013e3181a27777
Robboy, Stanley J., Ruthy Shaco-Levy, Ruth Y. Peng, Matthew J. Snyder, John Donahue, Rex C. Bentley, Sarah Bean, Hannah R. Krigman, Lawrence M. Roth, and Robert H. Young. “Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread.Int J Gynecol Pathol 28, no. 5 (September 2009): 405–22. https://doi.org/10.1097/PGP.0b013e3181a27777.
Robboy SJ, Shaco-Levy R, Peng RY, Snyder MJ, Donahue J, Bentley RC, et al. Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol. 2009 Sep;28(5):405–22.
Robboy, Stanley J., et al. “Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread.Int J Gynecol Pathol, vol. 28, no. 5, Sept. 2009, pp. 405–22. Pubmed, doi:10.1097/PGP.0b013e3181a27777.
Robboy SJ, Shaco-Levy R, Peng RY, Snyder MJ, Donahue J, Bentley RC, Bean S, Krigman HR, Roth LM, Young RH. Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol. 2009 Sep;28(5):405–422.

Published In

Int J Gynecol Pathol

DOI

EISSN

1538-7151

Publication Date

September 2009

Volume

28

Issue

5

Start / End Page

405 / 422

Location

United States

Related Subject Headings

  • Young Adult
  • Struma Ovarii
  • Risk Factors
  • Pathology
  • Ovarian Neoplasms
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Kaplan-Meier Estimate
  • Humans
  • Female