Ovarian goiter detected during post-operative follow-up of papillary thyroid cancer: a case report

Author:

Murayama Daisuke1ORCID,Toda Soji2,Okubo Yoichiro3,Hayashi Hiroyuki4,Iwasaki Hiroyuki2

Affiliation:

1. Department of Breast and Thyroid Surgery, Aizawa Hospital , 2-5-1 Honjo, Matsumoto, Nagano 390-8510 , Japan

2. Department of Breast and Endocrine Surgery, Kanagawa Cancer Center , 2-3-2 Nakao Asahi-ku, Yokohama, Kanagawa 241-8515 , Japan

3. Department of Pathology, Kanagawa Cancer Center , 2-3-2 Nakao Asahi-ku, Yokohama, Kanagawa 241-8515 , Japan

4. Department of Pathology, Yokohama Municipal Citizen’s Hospital , 1-1 Mitsuzawanishimachi Kanagawa-ku, Yokohama, Kanagawa 221-0855 , Japan

Abstract

Abstract A 70-year-old female without any past medical history underwent total thyroidectomy and central neck dissection for papillary thyroid cancer (PTC) (pT3bN1aM0 pStage II). Her post-operative thyroglobulin (Tg) level remained high (around 100 ng/mL), which increased to 366 ng/mL 5 years after surgery. Computed tomography revealed metastasis to the left III and right Vb and VI lymph nodes and an incidental ovarian tumor. Transvaginal ultrasonography and magnetic resonance imaging suspected malignancy, resulting in total hysterectomy and bilateral adnexal resection. A pathological diagnosis of ovarian goiter with no malignancy was then established. For lymph node metastasis of PTC, right neck dissection and left III lymph node resection were performed. Post-operative blood examination showed a significant decrease in the Tg level (5.9 ng/mL). In conclusion, systemic imaging or I-131 remnant ablation should be performed after total thyroidectomy, as evident in the present case in which Tg levels did not decrease after total thyroidectomy.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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