A Rare Case of Histologic Benign Struma Ovarii With Distant Metastasis
Bibliographic record
Abstract
Struma ovarii (SO) is a rare variant of ovarian teratoma composed mainly of mature thyroid tissue. It is usually benign in histology. We present a case of benign SO with frequent recurrence and widespread extra-ovarian seeding. A 28-year-old woman was diagnosed initially with dermoid cysts over the right ovary. Over a 7-year period, frequent recurrence of ovarian tumor was accompanied by peritoneal strumosis and distant metastasis to liver and lung. Bilateral salpingo-oophorectomy (BSO), total thyroidectomy (TT) and radioactive iodine (RAI) therapy were performed with successfully declining serum thyroglobulin. The patient remains on scheduled follow-up in clinic. Histologic benign SO to behave like biological malignancy with frequent recurrence and distant metastasis is exceptional. Tumor enriched expression of the vascular endothelial growth factor (VEGF) and p53 protein may explain the risk of malignant behavior. There is still a lack of consensus on how to choose the optimal management for histologically benign SO with metastatic behavior. Based on our limited case experience, BSO is preferred. TT and RAI therapy is mandatory if persistence of elevated serum thyroglobulin and wide-seeding of the tumor was detected by I 131 whole body scintigraphy or fluorodeoxyglucose (PET-FDG) scan. J Clin Gynecol Obstet. 2014;3(3):108-113 doi: http://dx.doi.org/10.14740/jcgo232w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".