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- W4384938998 abstract "A 75-year-old mother of ten suffering from a urinary tract infection developed macrohematuria and therefore an abdominal ultrasound was performed, followed by a CT scan when an unexpected large pelvic mass was discovered. Past history included hypertension, paroxysmal atrial fibrillation, and remote history of minor stroke (on candesartan, dabigatran, bisoprolol); bilateral chronic lymphedema; and hysterectomy due to prolapse at the age of 40. Imaging revealed nephrolithiasis and a prominent left adnexal mass suspected as ovarian cancer. MRI strongly supported the diagnosis, due to the size, suspicious characteristics, enhancement, and adjacent lymphadenopathy and deep vein thrombosis (Fig. 1, 2). Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) confirmed pathological uptake of FDG by the mass and lymph nodes (not shown) and ruled out distant spread. She had normocytic anemia (Hb 10.2 gr/dL, normal renal function) and elevated tumor marker CA-125 of 51.4 U/ml (N 0-35). Left salpingo-oophorectomy was performed. Surprisingly, extensive tumor sampling did not reveal cancer, but struma ovarii (mature teratoma). The lesion was composed of benign thyroid tissue (Fig. 2A (98% thyroglobulin-positive) (Fig. 2B) and small area of bone tissue. TSH and serum thyroglobulin were normal. The patient recovered uneventfully and remains well on follow-up of 12 months. Dabigatran was continued and macrohematuria did not recur. Figure 2H&E stain demonstrated macro- and microfollicles filled with colloid and consistent with mature thyroid tissue composing almost the entire tumor (A) and 98% strongly reactive for thyroglobulin (B) (X20). View Large Image Figure Viewer Download Hi-res image" @default.
- W4384938998 created "2023-07-22" @default.
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- W4384938998 date "2023-07-01" @default.
- W4384938998 modified "2023-10-14" @default.
- W4384938998 title "On Hoofs and Zebras – Struma Ovarii" @default.
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- W4384938998 doi "https://doi.org/10.1016/j.amjmed.2023.06.029" @default.
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