STRUMA OVARII COEXISTING WITH DERMATOMYOSITIS - AN UNUSUAL ASSOCIATION

Abstract

Dermatomyositis is an idiopathic inflammatory myopathy with cutaneous involvement. In patients over 60 years may be associated with underlying neoplasms. The most frequently involved are the lung, ovary and digestive system. The Struma ovarii is a rare ovarian tumor, which is defined by the presence of thyroid tissue, associated to a teratoma or a mucinous cystadenoma. There are benign and malignant histological variants. We present the case of a 56-years-old, Caucasian woman, without previous relevant history, with a dermatosis of three months of evolution, consisting of dispersed scaly erythematous plaques, distributed by the face, both thighs and back, with sizes ranging from 20 to 10 cm. The patient was initially treated with corticosteroids and antimalarial drugs, without improvement.

Skin biopsy revealed lupus panniculitis. Muscle biopsy was normal. CT body scan had thickening of the endometrium.

Transvaginal ultrasound showed atypical morphology of the right ovary. Thyroid ultrasonography and thyroid function were normal. The patient underwent laparoscopic hysterectomy with bilateral adnexectomy. The result of the surgical specimen revealed Struma ovarii in the right ovary and small serous adenofibroma in the surface. Currently the patient is treated with oral prednisone and azathioprine with significant clinical improvement. In this case the importance of screening for underlying malignancy revealed a benign tumor of ovary (struma ovarii), which is a very rare histological variant.