Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2961
Peer-review started: November 14, 2021
First decision: December 10, 2021
Revised: December 22, 2021
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: March 26, 2022
Processing time: 128 Days and 9.5 Hours
Struma ovarii is a rare specific ovarian tumor. It is a highly differentiated monodermal teratoma with a malignant transformation rate as low as 5%. Thus, malignant transformation and metastasis are extremely rare. The clinical manifestations of this disease are not typical and are easily misdiagnosed.
A 55-year-old female patient had a history of pain in the right hepatic region for approximately 1 year. Computed tomography and magnetic resonance imaging showed a solid cystic mass in the right adnexal region and a solid mass in the right retroperitoneum. The patient underwent surgical resection, and the combined morphological and immunohistochemical results led to the final diagnosis of right struma ovarii with papillary carcinoma and right retroperitoneal lymph node metastasis.
Malignant struma ovarii with distant metastasis is extremely rare, and the clinical manifestations of this disease are nonspecific. Accurate preoperative diagnoses are difficult to obtain, and pathological examination is the gold standard for diagnosing this disease.
Core Tip: Malignant struma ovarii (MSO) with biologically malignant behavior is an extremely rare disease. The rarity of MSO and the nonspecific clinical presentation make it very difficult to diagnose preoperatively. We report a case of MSO, for which we analyzed a combination of pathological and immunohistochemical findings, to improve the understanding of this disease. A clear preoperative diagnosis of MSO can be particularly helpful for doctors in formulating the best treatment plan, allowing patients to avoid unnecessary treatments to the greatest extent possible.