Thyroid gland ectopia to the ovary resulting in papillary thyroid cancer with carcinomatosis
- Authors: Naymushina P.A.1, Shevtsov D.V.1, Uskova N.G.1, Abramov D.S.1, Konovalov D.M.1, Akhaladze D.G.1, Grachev N.S.1
-
Affiliations:
- The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
- Issue: Vol 24, No 1 (2025)
- Pages: 181-187
- Section: CLINICAL OBSERVATIONS
- Submitted: 28.03.2025
- Accepted: 28.03.2025
- Published: 08.07.2025
- URL: https://hemoncim.com/jour/article/view/977
- DOI: https://doi.org/10.24287/1726-1708-2025-24-1-181-187
- ID: 977
Cite item
Full Text
Abstract
Thyroid gland ectopia is a rare condition occurring as a developmental anomaly during the embryonic period, when the thyroid primordium migrates. The prevalence of thyroid gland ectopia is 1 per 100 000–300 000 healthy individuals. Struma ovarii is a variant of thyroid gland ectopia, defined by the presence of thyroid tissue in the ovary. Cases of struma ovarii are very rare, and in the pediatric population they are even more rare than in adults. Only a few cases of struma ovarii in patients under 18 years have been described in the literature. Here, we present a clinical case of papillary thyroid cancer in ectopic thyroid tissue in a 13-year-old girl. The patient's parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications. Surgery remains the main treatment option for all histological subtypes of thyroid cancer, however patients with distant metastasis are treated with radioactive iodine therapy. In this case, as adjuvant therapy, the patient received a combination of thyroidectomy and radioactive iodine therapy due to the presence of implantation metastases. Malignant transformation of ectopic thyroid tissue is extremely rare, and it may be difficult for a clinician to determine the best treatment option due to the lack of uniform treatment guidelines for this disease. This case report describes the clinical course of struma ovarii as well as an option for surgical treatment and adjuvant therapy for this disease.
About the authors
P. A. Naymushina
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: polina.naymushina1@gmail.com
Polina A. Naymushuna - a pediatric oncologist at the Department of Adolescent Hematology/Oncology
1 Samory Mashela St., 117997, Moscow
Russian FederationD. V. Shevtsov
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Moscow
Russian FederationN. G. Uskova
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Moscow
Russian FederationD. S. Abramov
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Moscow
Russian FederationD. M. Konovalov
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
ORCID iD: 0000-0001-7732-8184
Moscow
Russian FederationD. G. Akhaladze
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
Moscow
Russian FederationN. S. Grachev
The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation
ORCID iD: 0000-0003-0547-0899
Moscow
Russian FederationReferences
- Kim M.S., Kong Y.H., Lee D.Y. A Case of Subclinical Hypothyroidism with Lingual and Right Pretracheal Ectopic Thyroid. J Clin Res Pediatr Endocrinol 2015; 7 (2): 148–50.
- Yoo S.C., Chang K.H., Lyu M.O., Chang S.J., Ryu H.S., Kim H.S. Clinical characteristics of struma ovarii. J Gynecol Oncol 2008; 19: 135–8.
- Ciccarelli A., Valdes-Socin H., Parma J., Khoo S.K., Schoumans J., Colao A., et al. Thyrotoxic adenoma followed by atypical hyperthyroidism due to struma ovarii: clinical and genetic studies. Eur J Endocrinol 2004; 150: 431–7.
- Robboy S.J., Shaco-Levy R., Peng R.Y., Snyder M.J., Donahue J., Bentley R.C., et al. Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol 2009; 28: 405–22.
- Young R.H. New and unusual aspects of ovarian germ cell tumors. Am J Surg Pathol 1993; 17 (12): 1210–24.
- Rosen R.D., Sapra A. Embryology, thyroid. In: StatPearls Knowledge Base; 2019.
- Sauk J.J. Ectopic lingual thyroid. J Pathol 1970; 102: 239–45.
- Zalel Y., Seidman D.S., Oren M., Achiron R., Gotlieb W., Mashiach S., Goldenberg M. Sonographic and clinical characteristics of struma ovarii. J Ultrasound Med 2000; 19: 857–61.
- Ibrahim N.A., Fadeyibi I.O. Ectopic thyroid: etiology, pathology and management. Hormones 2011; 10: 261–9.
- De Felice M., Di Lauro R. Thyroid development and its disorders: genetics and molecular mechanisms. Endocr Rev 2004; 25 (5): 722–46.
- Moayerifar M., Koohmanaee S., Nakhochari A.M., Rad A.H., Dalili S. Malignant struma ovarii in an 11-year-old girl. J Pediatr Surg Case Rep 2018; 29: 1–4.
- Ezon I., Zilbert N., Pinkney L., Wei J.-J., Malik R., Nadler E.P. A large struma ovarii tumor removed via laparoscopy in a 16-year-old adolescent. J Pediatr Surg 2007; 42 (8): e19–22.
- Makani S., Kim W., Gaba A.R. Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature. Gynecol Oncol 2004; 94 (3): 835–9.
- Iltar E., Ureyen I., Toptas T., Savas M., Çekiç S., Uysal A. A Rare Case: Struma Ovarii in a 14-YearOld Girl. J Adolesc Young Adult Oncol 2018; 7 (1): 134–6.
- Alamdari M.I., Habibzadeh A., Pakrouy H., Chaichi P., Sheidaei S. An unusual presentation of a papillary thyroid carcinoma in the struma ovarii in a 10 year-old girl: A case report. Int J Surg Case Rep 2018; 51: 218–20.
- Bolotina L.V., Vladimirova L.Yu., Dengina N.V., Novik A.V., Romanov I.S. Practical guidelines for the treatment of malignant head and neck tumors. Malignant tumors 2021; 11 (3s2-1): 91–106. (In Russ.)].
- Rumyantsev A.G., Varfolomeeva S.R., Grachev N.S., Karachunsky A.I., Novichkova G.A. Principles and Tools of Evidence-Based Medicine in Pediatric Hematology/Oncology Doctor.Ru 2015; 10 (111): 6–13. (In Russ.)
- Ayhan S., Kilic F., Ersak B., Aytekin O., Akar S., Turkmen O., et al. Malignant struma ovarii: From case to analysis. J Obstet Gynaecol Res 2021; 47 (9): 3339–51.
- Hinshaw H.D., Smith A.L., Desouki M.M., Olawaiye A.B. Malignant transformation of a mature cystic ovarian teratoma into thyroid carcinoma, mucinous adenocarcinoma, and strumal carcinoid: a case report and literature review. Case Rep Obstet Gynecol 2012; 2012: 269489.
- Egan C., Stefanova D., Thiesmeyer J.W., Joo Lee Y., Greenberg J., Beninato T., et al. Proposed risk stratification and patterns of radioactive iodine therapy in malignant struma ovarii. Thyroid 2022; 32 (9): 1101–8.
Supplementary files
