Struma ovarii surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgery is the mainstay of treatment for | Surgery is the mainstay of treatment for struma ovarii. For benign cases of struma ovarii the treatment is surgical resection only. For malignant cases of struma ovarii an adjuvant treatment modalities such as [[radioiodine]] therapy and [[External beam radiation therapy|external beam radiation]] are recommended. | ||
==Surgery== | ==Surgery== | ||
Surgery is the mainstay of treatment for struma ovarii. | |||
For benign cases of struma ovarii the treatment is [[surgical resection]] only. For [[malignant]] cases of struma ovarii an adjuvant treatment may be needed, but recurrence is uncommon. <ref name="pmid19471561">{{cite journal |vauthors=Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS |title=Clinical characteristics of struma ovarii |journal=J Gynecol Oncol |volume=19 |issue=2 |pages=135–8 |year=2008 |pmid=19471561 |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |url=}}</ref> | |||
Preoperative radiological diagnosis is important to avoid [[ovarian cancer]] type [[surgery]] (bilateral [[salpingo-oophorectomy]], [[hysterectomy]], omentectomy and occasionally [[appendectomy]]). <ref name="pmid24357453">{{cite journal |vauthors=Dujardin MI, Sekhri P, Turnbull LW |title=Struma ovarii: role of imaging? |journal=Insights Imaging |volume=5 |issue=1 |pages=41–51 |year=2014 |pmid=24357453 |pmc=3948908 |doi=10.1007/s13244-013-0303-3 |url=}}</ref> | |||
In patients without disseminated disease, surgical excision has been opted as the preferred treatment because of it's fairly good prognosis. <ref name="pmid12172581">{{cite journal |vauthors=Kabukcuoglu F, Baksu A, Yilmaz B, Aktumen A, Evren I |title=Malignant struma ovarii |journal=Pathol. Oncol. Res. |volume=8 |issue=2 |pages=145–7 |year=2002 |pmid=12172581 |doi=PAOR.2002.8.2.0145 |url=}}</ref> | |||
In fertility-desiring patients, conservative surgery such as unilateral [[salpingo-oophorectomy]] may be opted for provided if the [[tumor]] is localized. <ref name="pmid12717308">{{cite journal |vauthors=Salomon LJ, Lefevre M, Cortez A, Antoine JM, Uzan S |title=[Struma ovarii: a rare tumor that deserves special management. Case report and review of the literature] |language=French |journal=J Gynecol Obstet Biol Reprod (Paris) |volume=32 |issue=2 |pages=175–8 |year=2003 |pmid=12717308 |doi= |url=}}</ref> <ref name="pmid27355004">{{cite journal |vauthors=Oudoux A, Leblanc E, Beaujot J, Gauthier-Kolesnikov H |title=Treatment and follow-up of malignant struma ovarii: Regarding two cases |journal=Gynecol Oncol Rep |volume=17 |issue= |pages=56–9 |year=2016 |pmid=27355004 |pmc=4913172 |doi=10.1016/j.gore.2016.05.014 |url=}}</ref> | |||
In [[postmenopausal]] women or in the case of extra ovarian extent, a total [[hysterectomy]] with bilateral [[salpingo-oophorectomy]] is preferred. <ref name="pmid15350384">{{cite journal |vauthors=Makani S, Kim W, Gaba AR |title=Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature |journal=Gynecol. Oncol. |volume=94 |issue=3 |pages=835–9 |year=2004 |pmid=15350384 |doi=10.1016/j.ygyno.2004.06.003 |url=}}</ref> <ref name="pmid27355004">{{cite journal |vauthors=Oudoux A, Leblanc E, Beaujot J, Gauthier-Kolesnikov H |title=Treatment and follow-up of malignant struma ovarii: Regarding two cases |journal=Gynecol Oncol Rep |volume=17 |issue= |pages=56–9 |year=2016 |pmid=27355004 |pmc=4913172 |doi=10.1016/j.gore.2016.05.014 |url=}}</ref> | |||
'''Surgical treatment is done by procedures such as:''' | '''Surgical treatment is done by procedures such as:''' | ||
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*Unilateral [[salpingo-oophorectomy]] | *Unilateral [[salpingo-oophorectomy]] | ||
*Extirpation of struma ovarii | *Extirpation of struma ovarii | ||
*For [[malignant]] struma ovarii, infra-colic omentectomy is preferred | *For [[malignant]] struma ovarii, infra-colic omentectomy is preferred | ||
*Bilateral ovariectomy <ref name="pmid3297279">{{cite journal |vauthors=Willemse PH, Oosterhuis JW, Aalders JG, Piers DA, Sleijfer DT, Vermey A, Doorenbos H |title=Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration |journal=Cancer |volume=60 |issue=2 |pages=178–82 |year=1987 |pmid=3297279 |doi= |url=}}</ref> | *Bilateral ovariectomy<ref name="pmid3297279">{{cite journal |vauthors=Willemse PH, Oosterhuis JW, Aalders JG, Piers DA, Sleijfer DT, Vermey A, Doorenbos H |title=Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration |journal=Cancer |volume=60 |issue=2 |pages=178–82 |year=1987 |pmid=3297279 |doi= |url=}}</ref> | ||
*Total [[thyroidectomy]] <ref name="pmid3297279">{{cite journal |vauthors=Willemse PH, Oosterhuis JW, Aalders JG, Piers DA, Sleijfer DT, Vermey A, Doorenbos H |title=Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration |journal=Cancer |volume=60 |issue=2 |pages=178–82 |year=1987 |pmid=3297279 |doi= |url=}}</ref> | *Total [[thyroidectomy]]<ref name="pmid3297279">{{cite journal |vauthors=Willemse PH, Oosterhuis JW, Aalders JG, Piers DA, Sleijfer DT, Vermey A, Doorenbos H |title=Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration |journal=Cancer |volume=60 |issue=2 |pages=178–82 |year=1987 |pmid=3297279 |doi= |url=}}</ref> | ||
*Omentectomy and occasionally [[appendectomy]] | *Omentectomy and occasionally [[appendectomy]]<ref name="pmid24357453">{{cite journal |vauthors=Dujardin MI, Sekhri P, Turnbull LW |title=Struma ovarii: role of imaging? |journal=Insights Imaging |volume=5 |issue=1 |pages=41–51 |year=2014 |pmid=24357453 |pmc=3948908 |doi=10.1007/s13244-013-0303-3 |url=}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 00:52, 16 October 2017
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American Roentgen Ray Society Images of Struma ovarii surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
Surgery is the mainstay of treatment for struma ovarii. For benign cases of struma ovarii the treatment is surgical resection only. For malignant cases of struma ovarii an adjuvant treatment modalities such as radioiodine therapy and external beam radiation are recommended.
Surgery
Surgery is the mainstay of treatment for struma ovarii.
For benign cases of struma ovarii the treatment is surgical resection only. For malignant cases of struma ovarii an adjuvant treatment may be needed, but recurrence is uncommon. [1]
Preoperative radiological diagnosis is important to avoid ovarian cancer type surgery (bilateral salpingo-oophorectomy, hysterectomy, omentectomy and occasionally appendectomy). [2]
In patients without disseminated disease, surgical excision has been opted as the preferred treatment because of it's fairly good prognosis. [3]
In fertility-desiring patients, conservative surgery such as unilateral salpingo-oophorectomy may be opted for provided if the tumor is localized. [4] [5]
In postmenopausal women or in the case of extra ovarian extent, a total hysterectomy with bilateral salpingo-oophorectomy is preferred. [6] [5]
Surgical treatment is done by procedures such as:
- Exploratory laparotomy
- Laparoscopic methods
Surgical treatment modalities include:
- Total hysterectomy with unilateral or bilateral salpingo-oophorectomy
- Unilateral salpingo-oophorectomy
- Extirpation of struma ovarii
- For malignant struma ovarii, infra-colic omentectomy is preferred
- Bilateral ovariectomy[7]
- Total thyroidectomy[7]
- Omentectomy and occasionally appendectomy[2]
References
- ↑ Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS (2008). "Clinical characteristics of struma ovarii". J Gynecol Oncol. 19 (2): 135–8. doi:10.3802/jgo.2008.19.2.135. PMC 2676458. PMID 19471561.
- ↑ 2.0 2.1 Dujardin MI, Sekhri P, Turnbull LW (2014). "Struma ovarii: role of imaging?". Insights Imaging. 5 (1): 41–51. doi:10.1007/s13244-013-0303-3. PMC 3948908. PMID 24357453.
- ↑ Kabukcuoglu F, Baksu A, Yilmaz B, Aktumen A, Evren I (2002). "Malignant struma ovarii". Pathol. Oncol. Res. 8 (2): 145–7. doi:PAOR.2002.8.2.0145 Check
|doi=value (help). PMID 12172581. - ↑ Salomon LJ, Lefevre M, Cortez A, Antoine JM, Uzan S (2003). "[Struma ovarii: a rare tumor that deserves special management. Case report and review of the literature]". J Gynecol Obstet Biol Reprod (Paris) (in French). 32 (2): 175–8. PMID 12717308.
- ↑ 5.0 5.1 Oudoux A, Leblanc E, Beaujot J, Gauthier-Kolesnikov H (2016). "Treatment and follow-up of malignant struma ovarii: Regarding two cases". Gynecol Oncol Rep. 17: 56–9. doi:10.1016/j.gore.2016.05.014. PMC 4913172. PMID 27355004.
- ↑ Makani S, Kim W, Gaba AR (2004). "Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature". Gynecol. Oncol. 94 (3): 835–9. doi:10.1016/j.ygyno.2004.06.003. PMID 15350384.
- ↑ 7.0 7.1 Willemse PH, Oosterhuis JW, Aalders JG, Piers DA, Sleijfer DT, Vermey A, Doorenbos H (1987). "Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration". Cancer. 60 (2): 178–82. PMID 3297279.