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