Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2022; 10(9): 2961-2968
Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2961
Malignant struma ovarii with papillary carcinoma combined with retroperitoneal lymph node metastasis: A case report
Wen Xiao, Jin-Rong Zhou, Dong Chen
Wen Xiao, Jin-Rong Zhou, Dong Chen, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Xiao W consulted the literature, collected the images, and wrote this paper; Zhou JR collected the clinical data and consulted the literature; Chen D designed the research, reviewed and revised the paper.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Chen, BMed, Chief Doctor, Professor, Department of Radiology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. cd999777@163.com
Received: November 14, 2021
Peer-review started: November 14, 2021
First decision: December 10, 2021
Revised: December 22, 2021
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: March 26, 2022
Processing time: 128 Days and 9.5 Hours
Abstract
BACKGROUND

Struma ovarii is a rare specific ovarian tumor. It is a highly differentiated monodermal teratoma with a malignant transformation rate as low as 5%. Thus, malignant transformation and metastasis are extremely rare. The clinical manifestations of this disease are not typical and are easily misdiagnosed.

CASE SUMMARY

A 55-year-old female patient had a history of pain in the right hepatic region for approximately 1 year. Computed tomography and magnetic resonance imaging showed a solid cystic mass in the right adnexal region and a solid mass in the right retroperitoneum. The patient underwent surgical resection, and the combined morphological and immunohistochemical results led to the final diagnosis of right struma ovarii with papillary carcinoma and right retroperitoneal lymph node metastasis.

CONCLUSION

Malignant struma ovarii with distant metastasis is extremely rare, and the clinical manifestations of this disease are nonspecific. Accurate preoperative diagnoses are difficult to obtain, and pathological examination is the gold standard for diagnosing this disease.

Keywords: Malignant struma ovarii; Papillary carcinoma; Metastasis; Radiology; Computed tomography; Magnetic resonance imaging; Case report

Core Tip: Malignant struma ovarii (MSO) with biologically malignant behavior is an extremely rare disease. The rarity of MSO and the nonspecific clinical presentation make it very difficult to diagnose preoperatively. We report a case of MSO, for which we analyzed a combination of pathological and immunohistochemical findings, to improve the understanding of this disease. A clear preoperative diagnosis of MSO can be particularly helpful for doctors in formulating the best treatment plan, allowing patients to avoid unnecessary treatments to the greatest extent possible.