• Leyi Shou, Jianfeng Lu, Junjie Yang, Huabing Wang, Lijun Sun, Hao Dong, and Yiqian Jiang.
• Department of Pathology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hagnzhou, Zhejiang.
• Medicine (Baltimore). 2023 Jan 6; 102 (1): e32658e32658.

IntroductionFollicular carcinoma originating from struma ovarii is a clinically rare low-grade malignant tumor. The pathological diagnosis of ovarian thyroid follicular carcinoma is predominantly based on the infiltrative growth and vascular involvement of tumor cell nests of different sizes in the ovarian parenchyma.Patient ConcernsHere we present a case of this malignancy in which the bilateral ovaries, right oviduct wall, myometrial surface, omentum, and bladder reflex were extensively involved Microscopically, the thyroid follicles in this case showed infiltrative growth of nodules of different sizes in the ovarian stroma.DiagnosisThe epithelial layer of the follicles was atypical, but with no nuclear features of papillary thyroid carcinoma such as nuclear groove and nuclear pseudoinclusions. Immunohistochemistry showed positive expression of thyroglobulin, thyroid transcription factor-1, and cytokeratin19, with a Ki-67 index of 5% +. Immunohistochemical results combined with microscopic morphology allowed a diagnosis of follicular carcinoma originating from struma ovarii.InterventionsAfter exclusion of contraindications to surgery, the patient underwent surgical exploration on July 26, 2022, during which frozen pathological examination was performed.OutcomesThe patient recovered well and was discharged. At the first follow-up visit in October 2022, the patient had an excellent survival.ConclusionThe analysis of the microscopic morphological characteristics and immunohistochemistry deepened our understanding of the pathological characteristics of ovarian and thyroid follicular carcinoma, and further provides a diagnostic reference for other clinicians who will encounter these conditions in the future.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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