Isolated Scapular Metastasis in a Patient with Malignant Struma Ovarii: A Case Report


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Abstract

UpdateThis article was updated on March 29, 2018, because of a previous error. On page 1, in the section titled “Case Report”, the sentence that had read “Immunohistochemical stains were positive for cytokeratin CAM 5.2, thyroid transcription factor-1 (TTF-1), and thyroglobulin, confirming the diagnosis of metastatic thyroid carcinoma (Figs. 6-B, 6-C, and 6-D).” now reads “Immunohistochemical stains were positive for cytokeratin CAM 5.2, thyroglobulin, and thyroid transcription factor-1 (TTF-1), confirming the diagnosis of metastatic thyroid carcinoma (Figs. 6-B, 6-C, and 6-D).” Additionally, on page 3, the legend for Figure 6 that had read “Figs. 6-A through 6-D Core biopsy results of the lesion in the left scapula. Fig. 6-A Staining shows a well-differentiated follicular neoplasm with a thyroid origin (hematoxylin and eosin, ×100). Immunohistochemical stains were positive for cytokeratin CAM 5.2 (Fig. 6-B), TTF-1 (Fig. 6-C), and thyroglobulin (Fig. 6-D).” now reads “Figs. 6-A through 6-D Core biopsy results of the lesion in the left scapula. Fig. 6-A Staining shows a well-differentiated follicular neoplasm with a thyroid origin (hematoxylin and eosin, ×100). Immunohistochemical stains were positive for cytokeratin CAM 5.2 (Fig. 6-B), thyroglobulin (Fig. 6-C), and TTF-1 (Fig. 6-D).”An erratum has been published: JBJS Case Connect. 2018 May 23;8(2):e35.Case:We report the case of a 38-year-old woman who presented with a lytic bone lesion in the left scapula. A biopsy showed a tumor with the histologic appearance of thyroid tissue. She also was found to have a thyroid nodule and an enlarged ovary, both of which were excised. The thyroid nodule turned out to be a benign colloid nodule, and the ovary contained a monodermal teratoma composed of thyroid tissue (struma ovarii). The lesion in the scapula eventually was proven to be metastatic malignant struma ovarii.Conclusion:Malignant struma ovarii with bone metastases is very rare, and its diagnosis is a challenge. There are some documented cases with bone metastases, mostly to the thoracic and lumbar spine. The optimal treatment of choice for the bone lesion is unknown because of the rarity of its presentation.

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