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  • Metastatic malignant struma ovarii to the pituitary presenting as a sellar mass and responding to total thyroidectomy with adjuvant radioactive iodine therapy

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Endocrinology
Metastatic malignant struma ovarii to the pituitary presenting as a sellar mass and responding to total thyroidectomy with adjuvant radioactive iodine therapy
  1. Ashini Dissanayake1,
  2. Angela Y. Liu2,
  3. Peter A. Gooderham3 and
  4. Jessica MacKenzie-Feder2
  1. 1 Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Division of Endocrinology ; Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Division of Neurosurgery ; Department of Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Jessica MacKenzie-Feder; jmfeder{at}phsa.ca

Abstract

Malignant struma ovarii (MSO) is a rare ovarian teratoma composed primarily of thyroid tissue. Common sites of metastasis include peritoneum, bone, liver, lung, gastrointestinal tract and omentum. We present a woman in her 50s with a history of remote oophorectomy presenting with hypopituitarism and a 2.7 cm sellar mass. Trans-sphenoidal surgery for presumed pituitary macroadenoma achieved near total resection and resultant pathology surprisingly showed ectopic thyroid tissue. The patient acquired her ovarian pathology report from Southeast Asia which showed struma ovarii of the left ovary. The pituitary mass was thus determined to be a metastatic lesion from MSO. She underwent total thyroidectomy and radioactive iodine ablation therapy with good initial response and no regrowth of the tissue or emergence of distant metastases after 5 years of annual follow-up. To our knowledge, this is the first reported case of MSO to the pituitary.

  • Pituitary disorders
  • Thyroid disease
  • Endocrinology
  • Gynecological cancer
  • Neurosurgery

https://doi.org/10.1136/bcr-2023-259391

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    Footnotes

    • Contributors AD, AYL, JM-F and PG were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. AD, AYL, JM-F and PG gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.