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(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. 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. 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 . 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 []. Up to 5-10% of all cases of struma ovarii are reported to be malignant. The diagnosis of a cystic struma ovarii is usually made on histopathology. The clinical records, CT and MRI features of twelve patients with pathologically proved SO were retrospectively analyzed. 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. 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. Diagnosis of Struma ovarii with medical imaging. 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. This diagnosis should be suggested in the differential diagnosis of patients with symptoms of thyroid disease and a normal thyroid gland. It contains about 2.7% of ovarian teratomas . 5-10% of struma ovarii become malignant, the only absolute criterion for which is the presence of metastasis. Best treatment for benign struma is laparoscopic operation. Struma ovarii is an ovarian tumor defined by the presence of thyroid tissue comprising >50% of the overall mass. Struma ovarii: A rare teratoid tumor of the ovary composed almost entirely of thyroid tissue, with large follicles containing abundant colloid. Ovarian teratoma tumor originated from monodermal layers of thyroid tissue is defined as struma ovarii [1]. 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. Occasionally there are symptoms of hyperthyroidism. Struma ovarii or monodermal teratoma is a specialized ovarian neoplasm which mainly constitutes mature thyroid tissue. Discussion. The symptoms of struma ovarii are similar to those of other ovarian tumors and are nonspecific in nature. Malignant SO is extremely rare and seen in about 5% of cases (19 cases reported from 1990-2008). Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. Nevertheless, Doppler flow may aid in the preoperative diagnosis of struma ovarii. It most commonly occurs as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. [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. Struma ovarii usually presents in the fifth decade of live [6]. Struma ovarii is a rare ovarian germ-cell tumor containing thyroid tissue. A diagnosis of struma ovarii should be considered in the differential diagnosis of pelvic masses in peri- and postmenopausal patients. 2011; 36(5):627-31 (ISSN: 1432-0509) Shen J; Xia X; Lin Y; Zhu W; Yuan J. Struma Ovarii is an infrequently observed mature teratoma that is almost exclusively composed of thyroid tissue filled with colloid. Diagnosis by preoperative imaging studies were 8 dermoid cysts, while only 3 cases were diagnosed as struma ovarii. FINAL DIAGNOSIS. Diagnosis. Struma ovarii is a mono-dermal variant of ovarian teratoma, which was first described by Von Klden in 1895 and Gottschalk in 1899 . Most commonly, they occur as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. Prognosis of benign strumosis and malignant struma ovarii without metastases is good. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. 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. 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. Hormonal findings revealed increased thyroid function, but the … In the present patient, we confirmed the positive expression of CK19, TTF-1, and Tg in the tumor, which suggested a malignant process. diagnosis of a malignant ovarian carcinoma preoperation. In some cases, it can cause hyperthyroidism. We present the cases of four women who were diagnosed with struma ovarii postoperatively. Figure 2: Struma ovarii (high power) Small groups of … The lungs lesions were confirmed to be follicular thyroid cancer by biopsy. all struma [1, 2] with distant metastases being reported in 5–23% of patients with malignant struma ovarii [3]. Abstract Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. 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 is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. BACKGROUND. Follicular Thyroid Carcinoma Arising in Struma Ovarii. CONTEXT: Struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. We report an unusual case of incidental diagnosis of struma ovarii after thyroidectomy for thyroid … METHODS: The clinical records, CT and MRI features of twelve patients with pathologically proved SO were retrospectively analyzed. It is a typically … CASE REPORT: A diagnosis of struma ovarii may be the source of many diagnostic problems. Blood flow signals, detected from the center of the echoic lesion, and low resistance to flow may be more common in struma ovarii. Introduction: Struma ovarii Description of Struma ovarii. 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]. Preoperative clinical diagnosis of struma ovarii, is very difficult. It is a rare benign tumor, accounting for 0.3-1% of the ovarian tumors and 2-3% of ovarian teratomas [2-4]. 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. Background. It is a rare tumor which comprises 1% of all ovarian tumors and 2.7% of all dermoid tumors. These patients, with mostly benign disease, often have more extensive surgery than necessary. It is usually a benign lesion but sometimes, malignant transformation could be observed. A 50-year-old woman with abdominal distention and dyspnoea was referred to our hospital. Distant metastasis of rare malignant struma ovarii (MSO) has been reported for cases associated with papillary thyroid cancer but few with follicular thyroid cancer. It is usually a benign condition; The diagnosis relies on histopathological examination and is infrequently made on routine investigations. 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. To reach the diagnosis of a struma ovarii, the tumor must either composed in more than 50% by thyroid component or with less Struma Ovarii With Hyperthyroidism. 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 … Struma ovarii: This is a rare type of ovarian tumor that’s made mostly of thyroid tissue. 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. Struma Ovarii (SO) is the most frequent monodermal ovarian teratoma and is defined as a teratoma composed primarily or exclusively of thyroid tissue. We performed TSHR staining in both the patient’s struma ovarii and in 3 cases of non-functioning struma ovarii. A 38-yr-old woman with struma ovarii that was initially diagnosed as “benign” presented with pulmonary metastasis and coughing 17 yr later. Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. When hyperthyroidism is caused by an ectopic thyroid … 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. 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. Ovary tumor - Struma ovarii. Abstract. It is usually a benign condition; however, malignant transformation is sometimes detected. [ 18 ] Read More Matsuda et al9 reported on a 48-year-old woman who presented with symptoms of hyperthyroidism and an ovarian mass. The present case further confirms the rare occurrence of Hashimoto thyroiditis in struma ovarii. In the wall of the cysts, small groups of thyroid follicles are also present. In summary, it is difficult to distinguish between struma ovarii and dermoid cysts on the basis of their sonographic appearance. 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. The pathological diagnosis was struma ovarii at right ovary. Struma ovarii is ectopic thyroid tissue associated with dermoid tumors or ovarian teratomas that can secrete excessive amounts of thyroid hormone and produce thyrotoxicosis. Imaging features were compared with pathological results. Introduction. 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