Malignant struma ovarii: an unusual presentation

Thyroid. 2001 Sep;11(9):889-92. doi: 10.1089/105072501316973163.


Malignant struma ovarii is a rare disease; only a few cases are well documented in the literature. Thus, the overall prognosis and modalities of treatment are still somewhat controversial. In this article, the authors report a case of malignant struma ovarii discovered 4 years after ovariectomy after metastasis to the lungs and bones. Review of the pathology of the ovarian struma did not reveal the classic criteria of malignancy, there were, however, many features considered to be atypical and thus suspicious. The patient was treated by total thyroidectomy followed by repetitive doses of 131I. However, because of difficulties in increasing the level of endogenous thyrotropin (TSH) because of functional thyroid metastases in such an advanced disease, recombinant human thyrotropin (rhTSH; Thyrogen, thyrotropin alpha, Genzyme Corporation, Cambridge, MA) was used before administration of radioiodine. With this therapeutic protocol, the patient is still clinically stable 2 years after diagnosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Bone Neoplasms / secondary
  • Combined Modality Therapy
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Recombinant Proteins / therapeutic use
  • Struma Ovarii / diagnosis*
  • Struma Ovarii / pathology
  • Struma Ovarii / secondary
  • Struma Ovarii / therapy*
  • Thyroidectomy
  • Thyrotropin / therapeutic use
  • Tomography, X-Ray Computed


  • Iodine Radioisotopes
  • Recombinant Proteins
  • Thyrotropin