Yang Bai, Xin Lu

Gynecological oncology, Obstetrics and Gynecology Hospital of Fudan University

Objective:Struma ovarii and ovarian carcinoid are highly differentiated monodermal teratomas which is rare clinical disease. So far, it has not been fully understood, and the aim of this study is to highlight the clinical characteristics and management of struma ovarii and ovarian carcinoid. Method: We performed a retrospective analysis of a total 52 cases of struma ovarii from January 1st 2003 to January 1st 2015 at our institutions. The collected information contains clinical and imaging features, pathological characteristics, diagnoses and treatment of struma ovarii and ovarian carcinoid. Result: There is a wide range of patients ages of struma ovarii (12-75yeas old), with a mean age of 43 years old and median age of 45 years old. The most common initial symptom was palpable mass (n=3, 6.8%), followed by lower abdominal pain (n=2, 4.5%) and vaginal bleeding (n=2, 4.5%). The majority of cases (n=37, 84.1%) had not declared any special symptoms. Ultrasound examination showed that great majority of struma ovarii were cystic-solid tumors (n=28, 65.9%). 34 patients were available for the examination of serum CA-125 levels, and among them 5(14.7%) had tested value being increased. 5(11.4%) patients had ascites at initial surgery, without finding any malignant cells in the cytological examination. Approximately 43.2% (n=19) of struma ovarii were treated with oophorocystectomy, 29.5% (n=13) with hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO), 20.5% (n=9) with simple salping-oophenrectomy. Ovarian carcinoid tended to occur during the menopausal transition, with a mean age of 51 years old and a median age of 52 years old. The tumor sizes was ranged from 5 to 11 cm. Two cases of them showed lower abdominal pain, one example had been with severe constipation. The rest of the 6 cases had no special symptom. All the cases performed operation, and 5 patients (62.5%) underwent the cytoreductive surgery, 2 patients (25.0%) with hysterectomy and bilateral salpinggo-oophorectomy(TAH-BSO), only 1 patient have fertility-sparing surgery which was Simple salping -oophenrectomy. Two of those with cytoreductive surgery respectively had PEB and PVB chemotherapy until the patient received the complete remission. Conclusion: The presented clinical, laboratory and imaging findings of patients are very diverse. But, nonetheless, the final diagnosis was still rely on the pathological report, and surgery is the only treatment method. To better understand the struma ovarii and ovarian carcinoid still needs further research.

Key Words: Struma ovarii, Strumal, carcinoid, Clinical character