Malignant struma ovarii in pregnancy: A case report
Bibliographic record
Abstract
Introduction: Struma ovarii are a rare type of cystic teratomas that are composed predominantly or entirely of thyroid tissue and account for less than 1 % of all ovarian tumours. Malignant presentations are even less common, accounting for approximately 5 % of struma ovarii. Due to their rarity, evidence to inform management is very limited. We report a distinctive case of a 27 year-old patient with malignant struma ovarii (MSO) during pregnancy. Case Presentation: The patient presented with acute lower abdominal pain and was treated with a laparoscopic cystectomy for ovarian torsion. Pathology revealed a 3 cm MSO with a component of papillary thyroid carcinoma arising in an 11.2 cm mature cystic teratoma. The patient became pregnant while pathology results were pending. Given the absence of most high-risk features such as presence of surface adhesions, tumor size greater than 5-10 cm, ascites greater than 1 L, or extra-capsular extension, she was deemed suitable for close observation during pregnancy with serial ultrasounds. At term, she underwent an elective repeat cesarean section, with a concomitant completion unilateral salpingo-oophorectomy and omentectomy. Four months later, a recurrence was detected in the abdominal and pelvic lymph nodes, which was managed with cytoreductive surgery and total thyroidectomy, followed by radioactive iodine (RAI) therapy. Three years after her initial diagnosis, the patient remains well without biochemical or radiologic evidence of recurrence. Discussion: MSO are rare and treatment should be individualized. In select cases, fertility-sparing management can be considered. The role of thyroidectomy and RAI therapy remains a topic of debate.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".