Indian Journal of Nuclear Medicine
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Year : 2022  |  Volume : 37  |  Issue : 2  |  Page : 162-165

High dose radioiodine therapy preceded by fertility preservation surgery in metastatic malignant struma ovarii: A tale of endurance and prudent management

1 Department of Nuclear Medicine and PETCT, Aster Medcity, Kochi, Kerala, India
2 Department of Endocrinology, Aster Medcity, Kochi, Kerala, India
3 Department of Surgical Oncology, Aster Medcity, Kochi, Kerala, India
4 Department of Clinical Pathology, Aster Medcity, Kochi, Kerala, India

Correspondence Address:
Dr. Shagos Gopalannair Santhamma
Department of Nuclear Medicine and PETCT, Aster Medcity, Kochi - 682 027, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnm.ijnm_77_21

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Struma ovarii is a type of mature ovarian teratoma which accounts for roughly 0.5%–1% (1) of all ovarian tumours and approximately 3% of all ovarian teratomas (2). To be classified as struma ovarii, more than 50% of the tumour must be comprised of thyroid tissue (3). Malignant struma ovarii being rare, no proper guidelines exists regarding its surgical approach or postoperative management. Metastatic malignant struma ovarii, in addition to radical surgery for ovarian mass will require total thyroidectomy to facilitate high dose radioiodine therapy. Here we present the case of a newly married, nulliparous, young lady in her third decade who was diagnosed with malignant struma ovarii with metastatic deposits in fallopian tube and extensive deposits in mesentery and peritoneum., She underwent cryopreservation of embryos followed by bilateral salphingo-oopherectomy + omentectomy + stripping of peritoneum over bladder, abdominal side walls, pelvic peritoneum + appendectomy with preservation of uterus. Total thyroidectomy was done simultaneously. Subsequently she underwent high dose radioiodine therapy. Complete ablation of the residual metastatic deposits were achieved by one sitting of therapy.

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