Struma ovarii pathophysiology: Difference between revisions

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==Genetics==
==Genetics==
*[Disease name] is transmitted in [mode of genetic transmission] pattern.
*Malignant struma ovarii (MSO) are rare tumors which arise from ectopic thyroid tissue in the ovary which is benign.
*Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
*Malignant struma ovarii (MSO) are classified histologically as papillary thyroid carcinomas (PTC). The genes involved in the pathogenesis of Malignant struma ovarii (MSO) include BRAF (35% to 69%), RAS (10%), and RET (5% to 30%).
*The development of [disease name] is the result of multiple genetic mutations.
*The development of Malignant struma ovarii (MSO) along with papillary thyroid carcinomas (PTC) features is associated with mutations in the BRAF of the type which is commonly observed in PTC, therefore it suggests a common pathogenesis for all PTCs regardless of their location. On the contrary, mutations in the RET/RAS/RAF pathway are not observed  in BSO. <ref name="pmid17721188">{{cite journal |vauthors=Schmidt J, Derr V, Heinrich MC, Crum CP, Fletcher JA, Corless CL, Nosé V |title=BRAF in papillary thyroid carcinoma of ovary (struma ovarii) |journal=Am. J. Surg. Pathol. |volume=31 |issue=9 |pages=1337–43 |year=2007 |pmid=17721188 |doi=10.1097/PAS.0b013e31802f5404 |url=}}</ref>
 
==Associated Conditions==
==Associated Conditions==
*Adenomatous or colloid cervical goiters. <ref name="pmid5448747">{{cite journal |vauthors=Kempers RD, Dockerty MB, Hoffman DL, Bartholomew LG |title=Struma ovarii--ascitic, hyperthyroid, and asymptomatic syndromes |journal=Ann. Intern. Med. |volume=72 |issue=6 |pages=883–93 |year=1970 |pmid=5448747 |doi= |url=}}</ref>
*Adenomatous or colloid cervical goiters. <ref name="pmid5448747">{{cite journal |vauthors=Kempers RD, Dockerty MB, Hoffman DL, Bartholomew LG |title=Struma ovarii--ascitic, hyperthyroid, and asymptomatic syndromes |journal=Ann. Intern. Med. |volume=72 |issue=6 |pages=883–93 |year=1970 |pmid=5448747 |doi= |url=}}</ref>

Revision as of 17:14, 17 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

  • The exact pathogenesis of [disease name] is not fully understood.

OR

  • It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
  • [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
  • Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
  • [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
  • The progression to [disease name] usually involves the [molecular pathway].
  • The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

  • The exact pathogenesis of [disease name] is not fully understood.

OR

  • It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
  • [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
  • Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
  • [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
  • The progression to [disease name] usually involves the [molecular pathway].
  • The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

  • Malignant struma ovarii (MSO) are rare tumors which arise from ectopic thyroid tissue in the ovary which is benign.
  • Malignant struma ovarii (MSO) are classified histologically as papillary thyroid carcinomas (PTC). The genes involved in the pathogenesis of Malignant struma ovarii (MSO) include BRAF (35% to 69%), RAS (10%), and RET (5% to 30%).
  • The development of Malignant struma ovarii (MSO) along with papillary thyroid carcinomas (PTC) features is associated with mutations in the BRAF of the type which is commonly observed in PTC, therefore it suggests a common pathogenesis for all PTCs regardless of their location. On the contrary, mutations in the RET/RAS/RAF pathway are not observed in BSO. [1]

Associated Conditions

  • Adenomatous or colloid cervical goiters. [2]
  • Hyperthyroidism in postmenopausal woman. [3]
  • Pseudo-Meig's syndrome [4]
  • Hashimoto's thyroiditis [5]
  • Thyrotoxicosis [5]

Gross Pathology

  • On gross pathological examination, Struma ovarii characteristically presents as a: [6] [7]
  • Solid and cystic tumor.
  • Tumor with several nodules partially separated by gray whitish fibrous tissue.
  • Nodules appear tan-brown in color with small dark red areas.
  • Cystic spaces filled with yellow-brown or straw-colored fluid.
  • Focal areas of calcification are observed.

Microscopic Pathology

  • On microscopic histopathological analysis the tumor was initially diagnosed as granulosa cell tumor in frozen study but finally turned out to be Struma Ovarii which is the characteristic finding of Struma ovarii. [4]
  • Hematoxylin and eosin-stained tissue helps analyze branching papillae with atypical cytologic features including nuclear groves, clearing, overlapping, and enlargement, consistent with papillary thyroid carcinoma arising in a struma ovarii. [8]
Microscopic appearance of the resected tumor. [4]
Hematoxylin and eosin-stained tissue (400×) displaying branching papillae with atypical cytologic features including nuclear groves, clearing, overlapping, and enlargement, consistent with papillary thyroid carcinoma arising in a struma ovarii. [8]

References

  1. Schmidt J, Derr V, Heinrich MC, Crum CP, Fletcher JA, Corless CL, Nosé V (2007). "BRAF in papillary thyroid carcinoma of ovary (struma ovarii)". Am. J. Surg. Pathol. 31 (9): 1337–43. doi:10.1097/PAS.0b013e31802f5404. PMID 17721188.
  2. Kempers RD, Dockerty MB, Hoffman DL, Bartholomew LG (1970). "Struma ovarii--ascitic, hyperthyroid, and asymptomatic syndromes". Ann. Intern. Med. 72 (6): 883–93. PMID 5448747.
  3. Nonne N, Ameyar-Zazoua M, Souidi M, Harel-Bellan A (2010). "Tandem affinity purification of miRNA target mRNAs (TAP-Tar)". Nucleic Acids Res. 38 (4): e20. doi:10.1093/nar/gkp1100. PMC 2831319. PMID 19955234.
  4. 4.0 4.1 4.2 Mostaghel N, Enzevaei A, Zare K, Fallahian M (2012). "Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report". J Ovarian Res. 5: 10. doi:10.1186/1757-2215-5-10. PMC 3350392. PMID 22436494.
  5. 5.0 5.1 Morrissey K, Winkel C, Hild S, Premkumar A, Stratton P (2007). "Struma ovarii coincident with Hashimoto's thyroiditis: an unusual cause of hyperthyroidism". Fertil. Steril. 88 (2): 497.e15–7. doi:10.1016/j.fertnstert.2006.11.095. PMC 2753978. PMID 17276434.
  6. Piérard GE, Piérard-Franchimont C (1987). "[Acute and chronic borrelioses transmitted by ticks along the Meuse River and in bordering regions]". Rev Med Liege (in French). 42 (3): 101–6. PMID 3563194.
  7. Gaitan E, Cooksey RC, Meydrech EF, Legan J, Gaitan GS, Astudillo J, Guzman R, Guzman N, Medina P (1989). "Thyroid function in neonates from goitrous and nongoitrous iodine-sufficient areas". J. Clin. Endocrinol. Metab. 69 (2): 359–63. doi:10.1210/jcem-69-2-359. PMID 2753978.
  8. 8.0 8.1 Alvarez DM, Lee V, Bhatt S, Dogra VS (2011). "Struma ovarii with papillary thyroid carcinoma". J Clin Imaging Sci. 1: 44. doi:10.4103/2156-7514.84322. PMC 3272908. PMID 22315711.

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