Malignant transformation is rare, occurring in <5% of struma ovarii cases. Concomitant struma ovarii and serous cystadenoma has been mentioned in only two case reports in the extensively searched medical literature. By definition, at least 50% of the tumor mass must be represented by thyroid tissue (3). Hatami M, Breining D, Owers RL et-al. 2008;19 (2): 135-8. The complications may include: Stress and anxiety due to fear of cancer of the ovary; Large tumor masses may get secondarily infected with bacteria or fungus; Hyperthyroidism: Presence of an overactive thyroid gland causing symptoms such as … 6. Struma ovarii is a rare type of mature teratoma, but its imaging features are rather distinct. Iodine-123 will be taken up by any functioning thyroid tissue, and is diagnostic of struma ovarii if seen in the adnexal region. Matsuki M, Kaji Y, Matsuo M et-al. Malignant struma ovarii is rarer still, ovarian teratomas with neural differentiation. Magnetic resonance imaging findings may be more characteristic: The cystic spaces demonstrate both high and low signal intensity on T1- and T2-weighted images. We report a rare occurrence of coexisting struma ovarii along with a serous cystadenoma in a 55 year old woman. intracranial teratoma with malignant transformation, mediastinal non-germinomatous germ cell tumors, mediastinal teratoma with malignant transformation. Gynecol. Malignant struma ovarii. What are the possible Complications of Struma Ovarii? To qualify as a struma ovarii tumors more than 50% of the tumor should be composed of thyroid tissue 7. Molecular analysis of tissues obtained from both the malignant struma ovarii and thyroid gland was performed. Struma ovarii: management and follow-up … Struma ovarii is a teratoma in which thyroid tissue is present exclusively or forms a grossly recognizable component of a more complex teratoma [ 8 ]. Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumor, derivate from monodermic teratomas. Sonographic and Pathologic Features of Struma Ovarii. Struma Ovarii. It represents 2–3% of all ovarian tumours and by definition must be comprised of at least half thyroid tissue [2–4]. The vast majority of struma ovarii tumors (90-95% 1,5) tend to be benign and therefore carry a good prognosis. We identified 10 such cases in our files. It accounts for 0.3-1% of all ovarian tumors and ~3% of all mature cystic teratomas 1. Invest. We discuss the approaches leading to the correct diagnosis and we review the management of the disease. The gross pathologic appearance of struma ovarii differs from that of mature cystic teratomas where struma ovarii consist of amber-colored thyroid tissue, with hemorrhage, necrosis, and fibrosis. We report a case of a 52-year-old woman with the typical signs and symptoms of hyperthyroidism, in whom the diagnosis of struma ovarii was missed. J Gynecol Oncol. Check for errors and try again. A careful examination for any thyroid microfollicles within fibrous septa or areas of solid stroma is key. Jung SI, Kim YJ, Lee MW et-al. Struma ovarii occurs in patients with a substantially higher average age than for those with common mature teratomas. * A struma always occurs as a pelvic mass, which may be palpable on physical examination, depending upon size and location. It represents about 0.01% of overall ovarian tumours, and 5 to 10% of struma ovarii. Radiographics. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. A clue to the diagnosis is the presence of a green to brown glairy fluid. First described by Von Klden in 1895 and Gottschalk in 1899, struma ovarii is the most common type of monodermal teratoma, and comprises about 3.0% of all ovarian teratomas. Scintigraphy showing increased radioiodine uptake in the pelvic mass compared to the thyroid is confirmatory. Background: Malignant struma ovarii (MSO) are rare tumors that arise from ectopic thyroid tissue in the ovary, benign struma ovarii (BSO). Struma ovarii is ectopic thyroid tissue associated with dermoid tumors or ovarian teratomas that can secrete excessive amounts of thyroid hormone and produce thyrotoxicosis. Radiographics. Struma Ovarii Struma Ovarii Nieminen, Usko; Numers, Claës; Widholm, Olof 1964-01-01 00:00:00 From the I Clinic (Professor Aarno Turunen, M.D.) There is no internal vascularity. 1. Struma ovarii causes overt thyrotoxicosis only rarely, depending on the amount of follicular tissue present in the neoplasia. The complications of Struma Ovarii may depend on whether the tumor is benign or malignant. Struma ovarii is a monodermal germ cell tumor first de-scribed by R. Boëttlin in 1889 [1]. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. and II Clinic (Professor Paavo Vara, M.D.) 28 (4): 969-83. A struma ovarii is a rare form of monodermal teratoma that contains mostly thyroid tissue, which may cause hyperthyroidism. Br J Radiol. Obstet. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. They usually present a palpable abdominal mass and the tumors are unilateral and range from very small lesions up to as large as 10 cm in diameter. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases.[2]. The mean age at diagnosis of MSO was 43 years old [ 6, 9 ]. Struma ovarii: MRI findings. Struma ovarii is an uncommon type of teratomas, difficult to identify without histopathological examination. 22 (6): 1305-25. Virchows Arch Path Arat. A struma ovarii (literally: goitre of the ovary) is a rare form of monodermal teratoma that contains mostly thyroid tissue, which may cause hyperthyroidism.[1]. 33 (6): 740-3. (1-6) It is defined as an ovarian teratoma that is composed predominantly of thyroid tissue (> 50%), or forms a … Struma ovarii is a rare ovarian tumor comprising less than 2% of ovarian teratomas (1), with only 5% of these being malignant tumors (2). References 1. -. * Pleural effusion and … Despite its name, struma ovarii is not restricted to the ovary. Most MSO are histologically classified as papillary thyroid carcinomas (PTC). Il peut subir les remaniements habituels du tissu thy- roïdien (adénome, thyroïdite, carci- nome) et se compliquer de thyréo- toxicose dans 5 % des cas environ. Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. Struma ovarii is a specialized or monodermal teratoma predominantly composed of mature thyroid tissue . The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. The patient exhibited menstrual disorders. Struma ovarii (SO) is a variant of dermoid tumors which completely or mainly composed of thyroid tissues. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":14478,"mcqUrl":"https://radiopaedia.org/articles/struma-ovarii-tumour/questions/1892?lang=us"}. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Case presentation: A 17-year-old patient was diagnosed with papillary thyroid cancer in struma ovarii. Struma ovarii is a rare teratoma of the ovary that may contain functional thyroid follicular tissue, among others. Cystic struma ovarii (with macrocystic change) By MD Christopher Otis and MD Liron Pantanowitz. Struma ovarii concurrently occurring with other ovarian epithelial tumors has been rarely reported. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. 7. 1997;43 (1): 68-72. Treatment is with surgical resection. Benign Struma Ovarii; Malignant Struma Ovarii; Recent clinical studies. It is predominantly hypoechoic with internal septa and multiple thin echogenic bands. The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. In this study, we … Most cases of MSO are subclinical. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. Although the preoperative suspicion of struma ovarii does not change the surgical attitude, it can modify and alert the clinician to the appropriate perioperative care of these patients, thereby diminishing their morbimortality. 8. 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