Liu Y, Tang GY, Liu L, Sun HM, Zhu HY. Giant struma ovarii with pseudo-Meigs’syndrome and raised cancer antigen-125 levels: A case report. World J Clin Cases 2022; 10(30): 11155-11161 [PMID: 36338236 DOI: 10.12998/wjcc.v10.i30.11155]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2022; 10(30): 11155-11161 Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11155
Giant struma ovarii with pseudo-Meigs’syndrome and raised cancer antigen-125 levels: A case report
Yan Liu, Gao-Yan Tang, Lu Liu, Hui-Min Sun, Hai-Yan Zhu
Yan Liu, Lu Liu, Department of Gynecology, Weifang People’s Hospital, Weifang 261032, Shandong Province, China
Gao-Yan Tang, Hai-Yan Zhu, Department of Oncology, Weifang People’s Hospital, Weifang 261032, Shandong Province, China
Hui-Min Sun, Department of Pathology, Weifang People’s Hospital, Weifang 261032, Shandong Province, China
Author contributions: Tang GY wrote the first draft of the manuscript; Liu Y and Liu L were responsible for treatment of the patient; Sun HM provided images of hematoxylin-eosin and immunohistochemistry; Zhu HY revised the manuscript; all authors have read and approved the final manuscript.
Supported bythe Shandong Medical and Health Technology Development Project, No. 202102080115.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: July 1, 2022 Peer-review started: July 1, 2022 First decision: August 1, 2022 Revised: August 12, 2022 Accepted: August 25, 2022 Article in press: August 25, 2022 Published online: October 26, 2022 Processing time: 111 Days and 18.9 Hours
Abstract
BACKGROUND
Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue, accounting for 1% to 3% of all ovarian teratomas and 0.3% to 1.0% of all ovarian tumors. Of which, struma ovarii with ascites and pleural effusion, called pseudo-Meigs’syndrome and raised cancer antigen-125 levels (CA 125) is even rarer.
CASE SUMMARY
This paper reports the diagnosis and treatment of a patient of struma ovarii with pseudo-Meigs’syndrome, presenting with the clinical features of ovarian carcinoma: Complex pelvic mass, gross ascites, right pleural effusion and markedly elevated serum CA 125 levels. During the operation, a cystic-solid mass about 20 cm × 10 cm × 5 cm in the right adnexa and a solid mass with the size of 3 cm × 2 cm × 0.1 cm in the left ovary were observed. She underwent right adnexectomy and resection of the left ovarian mass and histopathology revealed a mature left-sided ovarian teratoma and struma ovarii of right adnexal mass. During 1-year follow-up, the patient recovered well, tumor markers and other indicators returned to normal.
CONCLUSION
The diagnosis and treatment process of this case suggests that the clinical symptoms of struma ovarii with pseudo-Meigs’syndrome are lack specificity, which is easily misdiagnosed. Clinicians should improve the understanding of this disease, enhance the awareness of early screening, and improve the level of diagnosis and treatment.
Core Tip: Struma ovarii with pseudo-Meigs’syndrome and elevated serum cancer antigen-125 is easily preoperatively misdiagnosed as ovarian cancer, leading to unnecessary extended surgery. In this case, the patient of giant struma ovarii with pseudo-Meigs’syndrome underwent conservative surgery in the form of a right salpingo-oophorectomy, as there was no evidence of malignancy according to the preoperative biopsy and intraoperative frozen analysis. Besides, this patient was premenopausal and to our knowledge, she is the youngest with this disease.
