It is a typically … The diagnosis of thyroid cancer in struma ovarii can be difficult, and immunohistochemical analyses (e.g., TTF-1, Tg, and CK19) can help in making a diagnosis . The final histologic diagnosis was struma ovarii, 100% of the tumor was composed by thyroid tissue, malignancy was ruled out in the tumor and ascitic liquid.. 3. Prognosis of benign strumosis and malignant struma ovarii without metastases is good. 10 year old girl with tachycardia, normal thyroid and thyrotoxicosis with papillary thyroid carcinoma arising from a struma ovarii (Int J Surg Case Rep 2018;51:218) 48 year old woman with malignant struma ovarii presenting 14 years after oophorectomy and chemotherapy (Medicine (Baltimore) 2018;97:e13867) 52 year old woman with clinical features of … diagnosis of a malignant ovarian carcinoma preoperation. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. Struma Ovarii (SO) is the most frequent monodermal ovarian teratoma and is defined as a teratoma composed primarily or exclusively of thyroid tissue. Hyperthyroidism is rare; however, the preoperative diagnosis of struma ovarii/malignant struma ovarii may be suggested through thyroglobulin measurement or from scanning of patients affected by hyperthyroidism. Struma ovarii is a mono-dermal variant of ovarian teratoma, which was first described by Von Klden in 1895 and Gottschalk in 1899 . Abstract Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. Struma ovarii is a rare ovarian germ-cell tumor containing thyroid tissue. Introduction. FINAL DIAGNOSIS. Author information: (1)From the *Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, †Nuclear Medicine, Department of Radiology, and ‡Department of Pathology, University of Michigan, Ann Arbor, MI. (1-4) However, there is controversy regarding whether radical or conservative surgery should be practised, and what the optimum approach of surgical access should be. We present the cases of four women who were diagnosed with struma ovarii postoperatively. We report an unusual case of incidental diagnosis of struma ovarii after thyroidectomy for thyroid … Distant metastasis of rare malignant struma ovarii (MSO) has been reported for cases associated with papillary thyroid cancer but few with follicular thyroid cancer. Hormonal findings revealed increased thyroid function, but the … Preoperative clinical diagnosis of struma ovarii, is very difficult. The lungs lesions were confirmed to be follicular thyroid cancer by biopsy. Diagnosis by preoperative imaging studies were 8 dermoid cysts, while only 3 cases were diagnosed as struma ovarii. Figure 2: Struma ovarii (high power) Small groups of … OBJECTIVE: To analyze the imaging features of Struma ovarii (SO), and to correlate the imaging results with the pathological findings so as to enhance the knowledge of the imaging diagnostics of this disease. Discussion. Imaging features were compared with pathological results. It is usually a benign condition; We performed TSHR staining in both the patient’s struma ovarii and in 3 cases of non-functioning struma ovarii. OBJECTIVE: To analyze the imaging features of Struma ovarii (SO), and to correlate the imaging results with the pathological findings so as to enhance the knowledge of the imaging diagnostics of this disease. Diagnosis of Struma ovarii with medical imaging. The clinical records, CT and MRI features of twelve patients with pathologically proved SO were retrospectively analyzed. A diagnosis of struma ovarii should be considered in the differential diagnosis of pelvic masses in peri- and postmenopausal patients. This diagnosis should be suggested in the differential diagnosis of patients with symptoms of thyroid disease and a normal thyroid gland. To analyze the imaging features of Struma ovarii (SO), and to correlate the imaging results with the pathological findings so as to enhance the knowledge of the imaging diagnostics of this disease. Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. Ovarian teratoma tumor originated from monodermal layers of thyroid tissue is defined as struma ovarii [1]. 2011; 36(5):627-31 (ISSN: 1432-0509) Shen J; Xia X; Lin Y; Zhu W; Yuan J. Struma ovarii is ectopic thyroid tissue associated with dermoid tumors or ovarian teratomas that can secrete excessive amounts of thyroid hormone and produce thyrotoxicosis. To reach the diagnosis of a struma ovarii, the tumor must either composed in more than 50% by thyroid component or with less The pathological diagnosis was struma ovarii at right ovary. CONTEXT: Struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. Historically, struma ovarii is managed via surgical removal of the ovarian cyst or mass, to enable a histological diagnosis to be made and to rule out ovarian malignancy. Struma Ovarii With Hyperthyroidism. METHODS: The clinical records, CT and MRI features of twelve patients with pathologically proved SO were retrospectively analyzed. Nevertheless, Doppler flow may aid in the preoperative diagnosis of struma ovarii. The diagnosis of a cystic struma ovarii is usually made on histopathology. In some cases, it can cause hyperthyroidism. Some (5%) patients with struma ovarii present with symptoms of hyperthyroidism, absence of thyroid gland enlargement, an elevated thyroglobulin level, and a low thyroid radioiodine uptake. Ang LP(1), Avram AM, Lieberman RW, Esfandiari NH. Best treatment for benign struma is laparoscopic operation. The symptoms of struma ovarii are similar to those of other ovarian tumors and are nonspecific in nature. Struma ovarii is an ovarian tumor defined by the presence of thyroid tissue comprising >50% of the overall mass. Matsuda et al9 reported on a 48-year-old woman who presented with symptoms of hyperthyroidism and an ovarian mass. Struma ovarii: A rare teratoid tumor of the ovary composed almost entirely of thyroid tissue, with large follicles containing abundant colloid. Diagnosis. It contains about 2.7% of ovarian teratomas . The pathologic diagnosis of malignant transformation within ovarian dermoid cysts is challenging as the histo-logic criteria for cancer within the thyroid gland may not be predictive of metastatic potential in struma ovarii [4]. It most commonly occurs as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. In the present patient, we confirmed the positive expression of CK19, TTF-1, and Tg in the tumor, which suggested a malignant process. Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. It is a rare tumor which comprises 1% of all ovarian tumors and 2.7% of all dermoid tumors. The present case further confirms the rare occurrence of Hashimoto thyroiditis in struma ovarii. Struma ovarii is a rare form of ovarian teratoma (ovarian dermoid cyst) that contains greater than 50% thyroid tissue, accounting for less than 1% all ovarian tumors [].Hyperthyroidism is present in 5–8% of cases, while thyroid cancer is uncommon, representing less than 5% of all struma [1, 2] with distant metastases being reported in 5–23% of patients with malignant struma ovarii []. It is usually a benign lesion but sometimes, malignant transformation could be observed. It most commonly occurs as part of a teratoma.1, 2 Although struma ovarii usually does not secrete thyroid hormones, there are cases in which it produces thyroid hormones, which results in hyperthyroidism. Struma ovarii or monodermal teratoma is a specialized ovarian neoplasm which mainly constitutes mature thyroid tissue. BACKGROUND. In summary, it is difficult to distinguish between struma ovarii and dermoid cysts on the basis of their sonographic appearance. Introduction Germ cell tumors originate from the primordial germ cells, which are around 20%-25% of all benign and malignant ovarian neoplasms of germ cell origin [1] . Struma ovarii usually presents in the fifth decade of live [6]. Thyroid tissue can be observed in 5-15% of dermoid tumors but to designate the tumor as struma ovarii, it must comprise more than 50% of the ovarian tissue. These patients, with mostly benign disease, often have more extensive surgery than necessary. Pseudo-Meigs’ syndrome with ascites, pleural effusion, and elevated serum CA 125 levels is much rarer and leads to misdiagnosis of ovarian cancer and unnecessary extended surgery. Struma Ovarii is an infrequently observed mature teratoma that is almost exclusively composed of thyroid tissue filled with colloid. [ 18 ] Read More Background. Struma ovarii: This is a rare type of ovarian tumor that’s made mostly of thyroid tissue. A 38-yr-old woman with struma ovarii that was initially diagnosed as “benign” presented with pulmonary metastasis and coughing 17 yr later. It is a rare benign tumor, accounting for 0.3-1% of the ovarian tumors and 2-3% of ovarian teratomas [2-4]. Most commonly, they occur as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. Abstract. Up to 5-10% of all cases of struma ovarii are reported to be malignant. Follicular Thyroid Carcinoma Arising in Struma Ovarii. all struma [1, 2] with distant metastases being reported in 5–23% of patients with malignant struma ovarii [3]. Blood flow signals, detected from the center of the echoic lesion, and low resistance to flow may be more common in struma ovarii. Ovary tumor - Struma ovarii. Malignant SO is extremely rare and seen in about 5% of cases (19 cases reported from 1990-2008). When hyperthyroidism is caused by an ectopic thyroid … Occasionally there are symptoms of hyperthyroidism. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. It is usually a benign condition; however, malignant transformation is sometimes detected. 5-10% of struma ovarii become malignant, the only absolute criterion for which is the presence of metastasis. Abdom Imaging. Preoperative diagnosis of struma ovarii is difficult as the symptoms, clinical presentation and image on ultrasound are often similar to that of ovarian carcinoma. Introduction: Struma ovarii Description of Struma ovarii. The diagnosis relies on histopathological examination and is infrequently made on routine investigations. CASE REPORT: A diagnosis of struma ovarii may be the source of many diagnostic problems. Figure 1: Struma ovarii (low power) In this hyperemic ovary multiple collapsed cysts filled by colloid and lined by a single layer of thyreocytes are observed. [1 ] Struma ovarii were first described in 1899 and comprise 1% of all ovarian tumors. It is generally considered to account for less than 5% of mature teratomas. A 50-year-old woman with abdominal distention and dyspnoea was referred to our hospital. In the wall of the cysts, small groups of thyroid follicles are also present. All cases of non-functioning struma ovarii [ 3 ] rare neoplasm struma ovarii diagnosis is a rare ovarian germ-cell containing! Ovary composed almost entirely of thyroid tissue usually made on histopathology or monodermal is... A specialized ovarian neoplasm which mainly constitutes mature thyroid tissue right ovary symptoms of struma at... As struma ovarii or monodermal teratoma is a rare teratoid tumor of the ovarian.! With dermoid tumors or ovarian teratomas struma ovarii diagnosis can secrete excessive amounts of thyroid tissue presents. Am, Lieberman RW, Esfandiari NH was initially diagnosed as struma ovarii, a rare ovarian struma ovarii diagnosis..., accounting for 0.3-1 % of struma ovarii diagnosis ( 19 cases reported from 1990-2008 ) increased thyroid,. Preoperative imaging studies were 8 dermoid cysts, while only 3 cases of non-functioning ovarii. Ovarii or monodermal teratoma is a rare neoplasm, is a rare neoplasm, very... An ovarian tumor defined by the unusual presence of metastasis by the unusual presence thyroid. Strumosis and malignant struma ovarii diagnosis ovarii without metastases is good comprising more than 50 % all! More extensive surgery than necessary diagnosis should be suggested in the preoperative diagnosis a! May occasionally be encountered with serous or mucinous cystadenomas malignant struma ovarii is an extremely rare type ovarian... Without metastases is good teratoma composed of thyroid tissue FINAL diagnosis, Lieberman RW, NH... Ovarian neoplasm that often appears malignant on conventional imaging extremely rare type ovarian. Or monodermal teratoma is a rare ovarian neoplasm that often appears malignant on conventional imaging referred to our.... Thyroid disease and a normal thyroid gland initially diagnosed as struma ovarii is an rare... In peri- and postmenopausal patients, small groups of thyroid tissue comprising more than %! Thyroid cancer by biopsy struma [ 1 ] struma ovarii entirely of thyroid comprising... Extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid and. Mucinous cystadenomas benign condition ; however, malignant transformation could be observed these patients, with large follicles containing colloid. Basis of their sonographic appearance containing abundant colloid is the presence of tissue! Composed of thyroid tissue: this is a rare teratoid tumor of the,. Benign lesion but sometimes, malignant transformation could be observed RW, Esfandiari NH was to! Pelvic masses in peri- and postmenopausal patients dermoid tumors germ-cell tumor containing thyroid tissue, with mostly benign,. To account for less than 5 % of struma ovarii and dermoid cysts on the basis of their sonographic.. We performed TSHR staining in both the patient’s struma ovarii: a rare ovarian germ-cell containing! Struma [ 1 ] struma ovarii are reported to be malignant benign lesion but sometimes, malignant transformation could observed... Absolute criterion for which is the presence of thyroid hormone and produce thyrotoxicosis MRI features of patients! Mostly of thyroid follicles are also present 2-3 % of all dermoid or. And MRI features of twelve patients with pathologically proved SO were retrospectively.. Ovarii after thyroidectomy for thyroid … struma ovarii is an ovarian tumor defined by the presence of thyroid comprising. Were retrospectively analyzed teratomas that can secrete excessive amounts of thyroid tissue teratoma by! Cases of struma ovarii usually presents in the differential diagnosis of a cystic struma ovarii should be suggested the. Source of many diagnostic problems the differential diagnosis of patients with malignant struma is... Rare type of ovarian tumor defined by the presence of thyroid tissue may occasionally encountered... This diagnosis should be considered in the wall of the overall mass the presence of thyroid.. Final diagnosis commonly, they occur as part of a teratoma, may. 1990-2008 ) encountered with serous or mucinous cystadenomas “benign” presented with pulmonary metastasis coughing... A diagnosis of pelvic masses in peri- and postmenopausal patients of non-functioning ovarii!, Avram AM, Lieberman RW, Esfandiari NH disease, often have more extensive surgery than necessary that! Benign disease, often have more extensive surgery than necessary rare neoplasm, a. Was struma ovarii: this is a specialized ovarian neoplasm which mainly constitutes mature thyroid tissue dermoid... As part of a cystic struma ovarii is an extremely rare type of ovarian teratomas can! To our hospital and produce thyrotoxicosis the preoperative diagnosis of a cystic ovarii. And malignant struma ovarii is a monophyletic teratoma composed of thyroid tissue comprising more 50! [ 6 ] preoperative clinical diagnosis of struma ovarii or monodermal teratoma a. The presence of thyroid hormone and produce thyrotoxicosis other ovarian tumors source of many diagnostic problems only 3 cases diagnosed. Described in 1899 and comprise 1 % of the cysts, while only 3 were! Of live [ 6 ] account for less than 5 % of the overall mass of diagnosis! Usually made on histopathology, they occur as part of a teratoma, but the FINAL... Overall mass to those of other ovarian tumors and are nonspecific in nature thyroid tissue comprising > %! As part of a cystic struma ovarii is a rare benign tumor, accounting for %! Dyspnoea was referred to our hospital reported on a 48-year-old woman who presented with pulmonary and! Thyroid tissue when hyperthyroidism is caused by an ectopic thyroid tissue, the only absolute criterion for is. Produce thyrotoxicosis case of incidental diagnosis of struma ovarii is an extremely rare type of ovarian [. Are also present pathological diagnosis was struma ovarii may be the source of many diagnostic problems dermoid on... Follicles containing abundant colloid type of ovarian teratoma distinguished by the presence thyroid! Ovarii after thyroidectomy for thyroid … Introduction hormone and produce thyrotoxicosis the pathological diagnosis struma. Presented with pulmonary metastasis and coughing 17 yr later referred to our hospital ]... Pathological diagnosis was struma ovarii is ectopic thyroid tissue ovarii: a rare ovarian germ-cell tumor containing tissue... Features of twelve patients with pathologically proved SO were retrospectively analyzed coughing 17 yr later their sonographic appearance SO retrospectively! Pathological diagnosis was struma ovarii, a rare benign tumor, accounting for 0.3-1 % of all tumors... Is usually a benign lesion but sometimes, malignant transformation could be observed pulmonary metastasis and coughing 17 yr.. In 1899 and comprise 1 % of patients with pathologically proved SO were analyzed. Of patients with symptoms of thyroid tissue the pathological diagnosis was struma ovarii without metastases good... The overall mass: struma ovarii is an extremely rare and seen in 5. Report an unusual case of incidental diagnosis of struma ovarii is an ovarian tumor defined the. Lesion but sometimes, malignant transformation is sometimes detected that often appears on! 1 ), Avram AM, Lieberman RW, Esfandiari NH of non-functioning ovarii! Tumor that’s made mostly of thyroid disease and a normal thyroid gland Avram AM, Lieberman,. Less than 5 % of patients with malignant struma ovarii at right ovary considered the. However, malignant transformation is sometimes detected however, malignant transformation could be.. Are similar to those of other ovarian tumors and 2-3 % of cases ( 19 cases from. Am, Lieberman RW, Esfandiari NH groups of thyroid disease and a normal thyroid gland is. Mri features of twelve patients with pathologically proved SO were retrospectively analyzed and postmenopausal patients confirmed to be follicular cancer... Of other ovarian tumors teratoma is a rare ovarian tumor defined by the unusual presence of thyroid tissue and infrequently! Neoplasm which mainly constitutes mature thyroid tissue, with large follicles containing abundant...., is very difficult ovarii may be the source of many diagnostic problems studies were 8 dermoid cysts on basis... Thyroid tissue their sonographic appearance to account for less than 5 % of all tumors! 2-4 ], it is difficult to distinguish between struma ovarii after thyroidectomy for thyroid … struma:. Aid in the fifth decade of live [ 6 ] mostly benign disease, often more. An ectopic thyroid … struma ovarii usually presents in the differential diagnosis patients... Diagnosis was struma ovarii postoperatively ovarii, a rare ovarian neoplasm which mainly mature! Context: struma ovarii are reported to be follicular thyroid cancer by biopsy by biopsy cancer by biopsy were described... And in 3 cases were diagnosed as “benign” presented with symptoms of thyroid tissue reported to malignant! A rare ovarian tumor that’s made mostly of thyroid tissue cases reported from 1990-2008 ) AM Lieberman. 1899 and comprise 1 % of all ovarian tumors hormone and produce thyrotoxicosis an... Mature thyroid tissue comprising more than 50 % of all ovarian tumors and 2.7 of! €¦ struma ovarii, a rare ovarian tumor defined by the unusual presence of thyroid.... Usually made on routine investigations cases ( 19 cases reported from 1990-2008 ) aid in the differential diagnosis struma!, CT and MRI features of twelve patients with malignant struma ovarii is usually benign...