OVARIAN METASTASIS FROM THYROID-CARCINOMA 12 YEARS AFTER PARTIAL THYROIDECTOMY MIMICKING STRUMA OVARII - REPORT OF A CASE

A 29-year-old woman experienced abdominal swelling 12 years after unde rgoing partial thyroidectomy for follicular carcinoma of the thyroid w ith vascular invasion and 6 months after a right cerebral tumor that h ad caused hemiplegia had been excised. Laparotomy disclosed a solid an d cystic right ovarian tumor, 17 cm in greatest dimension, and a 12-cm tumor of the right adrenal gland. Microscopic examination showed a ma lignant tumor of the thyroid follicular type with frequent mitotic fig ures; other teratomatous elements were absent. Because of the interval since the thyroid cancer, the diagnosis of a malignant struma ovarii was initially considered. The patient rapidly developed widespread met astatic disease and died, supporting the interpretation that the ovari an tumor was a metastasis from the thyroid neoplasm. This case illustr ates that when other teratomatous elements are not identified, the dia gnosis of malignant struma ovarii should be made only when the possibi lity of spread from a prior thyroid neoplasm, possibly one treated man y years previously, has been excluded.