Article (Scientific journals)
Thyrotoxic adenoma followed by atypical hyperthyroidism due to struma ovarii: clinical and genetic studies
Ciccarelli, A.; Valdes Socin, Hernan Gonzalo; Parma, J. et al.
2004In European Journal of Endocrinology, 150 (4), p. 431-437
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Keywords :
Thyroid diseases; Endocrinopathy; Benign neoplasm; Teratoma; Endocrinology; Genetics; Hyperthyroidism; Symptomatology; Atypical; Adenoma; Thyroïde pathologie; Endocrinopathie; Tumeur bénigne; Tératome; Endocrinologie; Génétique; Hyperthyroïdie; Symptomatologie; Atypique; Adénome
Abstract :
[en] OBJECTIVE: Atypical forms of hyperthyroidism represent a diagnostic challenge for clinicians. Struma ovarii is an ovarian teratoma and constitutes a rare cause of ectopic thyroidal hormonal production. We describe a case of struma ovarii that combined two different sources of hyperthyroidism in the same patient and report genetic studies in order to contribute a better understanding of the autonomy and tumorigenesis of the struma ovarii. CASE REPORT: A 73-year-old nulliparous woman presented a thyroid toxic adenoma that was successfully treated with 10 mCi radioiodine. Unexpectedly, a new onset of hyperthyroidism prompted us to look for a second etiology. A whole-body scan with (123)I detected a pelvic hyperfixation suggesting struma ovarii, and a thyroid differentiated left ovarian teratoma 3 cm in size was surgically removed. We screened for mutations of thyroid-stimulating hormone receptor and Gs-alpha protein genes, as these mutations are common in thyroid adenomas. We did not identify any mutations. Androgen receptor study demonstrated a monoclonal status. Comparative genomic hybridization did not reveal any chromosomal abnormality. However, loss of heterozygosity analysis showed several structural abnormalities, compared with the majority of benign ovarian teratomas, which show a normal karyotype. CONCLUSIONS: This is the first well-documented report of thyrotoxic struma ovarii revealed after treatment of a single thyroid toxic adenoma. We have shown in this case that struma ovarii originates from a single germ cell, and, albeit benign, this tumor presents several chromosomal abnormalities. Struma ovarii-induced hyperthyroidism is likely to be mediated by mechanisms different from those of the classical thyroid toxic adenoma.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Ciccarelli, A.
Valdes Socin, Hernan Gonzalo  ;  Université de Liège - ULiège > Endocrinologie clinique
Parma, J.
Khoo, S. K.
Schoumans, J.
Colao, A.
Hamoir, Etienne ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Beckers, Albert ;  Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Language :
English
Title :
Thyrotoxic adenoma followed by atypical hyperthyroidism due to struma ovarii: clinical and genetic studies
Publication date :
April 2004
Journal title :
European Journal of Endocrinology
ISSN :
0804-4643
eISSN :
1479-683X
Publisher :
BioScientifica Ltd, Bristol, United Kingdom
Volume :
150
Issue :
4
Pages :
431-437
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 18 March 2010

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