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Follicular Proliferative Lesion Arising in Struma Ovarii

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초록

Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibited solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

Abstract

Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibited solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

참고문헌 (10)

  1. Kurman RJ, "WHO classification of tumours of female reproductive organs" (2014), IARC Press
  2. Kurman RJ, "Blaustein’s pathology of the female genital tract" (2010), Springer
  3. Roth LM, "Talerman A. Typical thyroid-type carcinoma arising in struma ovarii: a report of 4 cases and review of the literature", Int J Gynecol Pathol, 27, pp.496~506 (2008)
  4. Robboy SJ, "Malignant struma ovarii:an analysis of 88 cases, including 27 with extraovarian spread", Int J Gynecol Pathol, 28, pp.405~422 (2009)
  5. Zhang X, "Thyroid-type carcinoma of struma ovarii", Arch Pathol Lab Med, 134, pp.786~791 (2010)
  6. Roth LM, "The enigma of struma ovarii", Pathology, 39, pp.139~146 (2007)
  7. Shaco-Levy R, "Natural history of biologically malignant struma ovarii : analysis of 27 cases with extraovarian spread", Int J Gynecol Pathol, 29, pp.212~227 (2010)
  8. Shaco-Levy R, "Malignant struma ovarii:a blinded study of 86 cases assessing which histologic features correlate with aggressive clinical behavior", Arch Pathol Lab Med, 136, pp.172~178 (2012)
  9. Roth LM, "Highly differentiated follicular carcinoma arising from struma ovarii: a report of 3 cases, a review of the literature, and a reassessment of so-called peritoneal strumosis", Int J Gynecol Pathol, 27, pp.213~222 (2008)
  10. Boutross-Tadross O, "Follicular variant papillary thyroid carcinoma arising in struma ovarii", Endocr Pathol, 18, pp.182~186 (2007)

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