Malignant struma ovarii harboring a unique NRAS mutation: case report and review of the literature
| Autor: | Chiara Bampo, Eugenio Borsatti, Giorgio Giorda, Alessandro Sindoni, Lara Alessandrini, Tanja Baresic, Vincenzo Canzonieri, Carlo Gobitti, Giovanni Franchin |
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| Přispěvatelé: | Gobitti, C, Sindoni, A, Bampo, C, Baresic, T, Giorda, G, Alessandrini, L, Canzonieri, V, Franchin, G, Borsatti, E |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Malignant struma ovarii medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Adnexal mass GTP Phosphohydrolases Malignant transformation Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine Positron Emission Tomography Computed Tomography medicine Presacral space Humans Ovarian Teratoma Ovarian Neoplasms Ovarian cyst Struma ovarii business.industry Thyroidectomy Membrane Proteins I-131 General Medicine Malignant Struma Ovarii medicine.disease Struma Ovarii Treatment Treatment Outcome Papillary thyroid carcinoma 030220 oncology & carcinogenesis Radioiodine Female Radiology business |
| Zdroj: | HORMONES. 13 |
| ISSN: | 1109-3099 |
| DOI: | 10.14310/horm.2002.1750 |
| Popis: | Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Restaging with F-18-FDG-PE T/CT scan, abdominal CT and ultrasonography showed abnormalities in the perihepatic region and presacral space and left hypochondrium localizations. The patient underwent thyroidectomy, hepatic nodulectomy and cytoreductive peritonectomy: histopathological examination did not show any malignant disease in the thyroid and confirmed the presence of peritoneal localizations due to malignant SO; molecular analysis detected NRAS Q61K mutation in exon 3, whereas no mutations were identified on the BRAF gene. The patient underwent radioiodine treatment: serum Tg was decreased at first follow-up after three months of I-131-therapy. We believe that our case raises some interesting considerations. First, pathologists should be aware of this entity and should check for the presence of point mutations suggesting an aggressive disease behavior, which could be beneficial for an optimal therapeutic approach. Second, although most of the knowledge in this field comes from case reports, efforts should be made to standardize the management of patients affected by malignant SO, including use of practice guidelines. |
| Databáze: | OpenAIRE |
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