Struma ovarii is ectopic thyroid tissue associated with dermoid tumors or ovarian teratomas that can secrete excessive amounts of thyroid hormone and produce thyrotoxicosis. Histologic examination of tissues is a must to evaluate the extent of thyroid tissue in the teratoma, as well as for diagnostic purposes and differentiation from other types of ovarian tumors. It represents 2–3% of all ovarian tumours and by definition must be comprised of at least half thyroid tissue [2–4]. Struma ovarii: MRI findings. Gynecol. Malignant struma ovarii is rarer still, Obstet. Qian Y, Xiao Y, Zhen-Zhen L, Yu-Xin J, Jian-Chu LI, Na SU, Bo C, Bo Z Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2015 Jun;37(3):309-14. doi: 10.3881/j.issn.1000-503X.2015.03.012. struma ovarii and these can be corroborated by nuclear medicine. Hatami M, Breining D, Owers RL et-al. Imaging findings of complications and unusual manifestations of ovarian teratomas. 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]. 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. Br J Radiol. Benign Struma Ovarii; Malignant Struma Ovarii; Recent clinical studies. Struma Ovarii. 6. Struma ovarii is rare; less than 200 cases have been reported in the medical literature [3, 5]. A case report and review of the literature. Jung SE, Lee JM, Rha SE et-al. PMID: 26149143. A careful examination for any thyroid microfollicles within fibrous septa or areas of solid stroma is key. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Virchows Arch Path Arat. Invest. By definition, at least 50% of the tumor mass must be represented by thyroid tissue (3). [3], "Ovarian teratomas: tumor types and imaging characteristics", https://en.wikipedia.org/w/index.php?title=Struma_ovarii&oldid=986132365, Creative Commons Attribution-ShareAlike License, This page was last edited on 30 October 2020, at 00:14. 3. Malignant struma ovarii. * Pleural effusion and … 2008;19 (2): 135-8. 7. Scintigraphy showing increased radioiodine uptake in the pelvic mass compared to the thyroid is confirmatory. Discussion Le struma ovarii est un tératome mature monotissulaire rare. Radiographics. Owing to malignant struma ovarii (MSO) rarity, there has been some controversy about Case presentation: A 17-year-old patient was diagnosed with papillary thyroid cancer in struma ovarii. Molecular analysis of tissues obtained from both the malignant struma ovarii and thyroid gland was performed. 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 … Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. Sonographic and Pathologic Features of Struma Ovarii. Concomitant struma ovarii and serous cystadenoma has been mentioned in only two case reports in the extensively searched medical literature. The cystic spaces can demonstrate both high and low (from gelatinous colloid 3) signal intensity on T1 and T2 weighted images. Invest. {"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"}. Struma ovarii is a rare ovarian tumor that was first described in 1899. Obstet. Treatment is with surgical resection. 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. 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. and II Clinic (Professor Paavo Vara, M.D.) Struma ovarii is a specialized or monodermal teratoma predominantly composed of mature thyroid tissue . Les struma ovarii malins représentent 5 à 10 % de … Introduction. Despite its name, struma ovarii is not restricted to the ovary. The mean age at diagnosis of MSO was 43 years old [ 6, 9 ]. Abdom Imaging. Jung SI, Kim YJ, Lee MW et-al. Oncogenic activation of BRAF (35% to 69%), RAS (10%), or RET (5% to 30%) is common in PTC, and the mutations correlate with tumor subtype, patient age, and clinical behavior. While imaging features can be non-specific and overlap with other ovarian neoplasms, ultrasound and CT usually demonstrate a complex adnexal lesion with multiple cystic and solid areas, reflecting the gross pathologic appearance of the tumor 1. Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. 8. We identified 10 such cases in our files. The presence of areas of very low signal intensity on T2-weighted images, due to the viscous colloid material is sometimes considered as suggestive for the presence of struma ovarii tumor. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. To qualify as a struma ovarii tumors more than 50% of the tumor should be composed of thyroid tissue 7. What are the possible Complications of Struma Ovarii? Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumor, derivate from monodermic teratomas. A complex cystic lesion within the right adnexal region, which measures 57 x 55 x 46 mm (volume 75 mL). A suspicion of the … Iodine-123 will be taken up by any functioning thyroid tissue, and is diagnostic of struma ovarii if seen in the adnexal region. Cystic struma ovarii (with macrocystic change) By MD Christopher Otis and MD Liron Pantanowitz. The rate of malignant transformation in struma ovarii is extremely low. Struma ovarii is a rare cause of hyperthyroidism. A struma ovarii is a rare form of monodermal teratoma that contains mostly thyroid tissue, which may cause hyperthyroidism. Struma ovarii accounts for approximately 5 percent of all ovarian teratomas [2-4]. US demonstrates a complex appearance with multiple cystic and solid areas, findings that reflect the gross pathologic appearance of the tumor. It is defined by the presence of thyroid tissue comprising more than 50% of the … Malignant struma ovarii--a case report and review of the literature. Boettlin R. Uber zahnentwickelung in dermoid cysten des ovariums. Most cases of MSO are subclinical. Struma ovarii occurs in patients with a substantially higher average age than for those with common mature teratomas. In this study, we … Ascites may be present in up to a third of cases 7. 22 (6): 1305-25. Struma ovarii causes overt thyrotoxicosis only rarely, depending on the amount of follicular tissue present in the neoplasia. Etiology. Gynecol. Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. The patient exhibited menstrual disorders. Struma ovarii is a rare teratoma of the ovary that may contain functional thyroid follicular tissue, among others. There is no internal vascularity. Meigs JV. -. RAS mutations both in the PTC … Malignant transformation is rare, occurring in <5% of struma ovarii cases. J Gynecol Oncol. Struma ovarii is an uncommon type of teratomas, difficult to identify without histopathological examination. Park SB, Kim JK, Kim KR et-al. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases.[2]. Clinique: * The most frequently symptom is abdominal pain (50 %) though a high percentage (40 %) of patients were asymptomatic (1). 2000;73 (865): 87-90. 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. intracranial teratoma with malignant transformation, mediastinal non-germinomatous germ cell tumors, mediastinal teratoma with malignant transformation. No fat is evident in these lesions. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. 1997;43 (1): 68-72. Approximately 5-8% of cases can show symptoms or signs of thyrotoxicosis. Clinical characteristics of struma ovarii. Struma ovarii is a teratoma in which thyroid tissue is present exclusively or forms a grossly recognizable component of a more complex teratoma [ 8 ]. The diagnosis is histologic and retrospective after pelvic surgery. References 1. There is a slightly hyperechoic focus within the lesion which demonstrates post acoustic shadowing. Most MSO are histologically classified as papillary thyroid carcinomas (PTC). Struma ovarii: CT findings. 4. First described by R Boettin in 1889 7,8. We discuss the approaches leading to the correct diagnosis and we review the management of the disease. Ce terme est réservé aux tératomes comportant de façon exclusive ou prédominante du tissu thyroïdien. Struma ovarii is a rare ovarian tumor comprising less than 2% of ovarian teratomas (1), with only 5% of these being malignant tumors (2). 28 (4): 969-83. Unable to process the form. Struma ovarii is a monodermal germ cell tumor first de-scribed by R. Boëttlin in 1889 [1]. A clue to the diagnosis is the presence of a green to brown glairy fluid. The vast majority of struma ovarii tumors (90-95% 1,5) tend to be benign and therefore carry a good prognosis. It accounts for 0.3-1% of all ovarian tumors and ~3% of all mature cystic teratomas 1. Struma ovarii tumor is a subtype of an ovarian teratoma and is composed entirely or predominantly of thyroid tissue and containing variable-sized follicles with colloid material. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases. May be seen as a multiloculated cystic mass, with solid parts. 33 (6): 740-3. Struma ovarii is a rare type of mature teratoma, but its imaging features are rather distinct. Struma ovarii tumor is a subtype of an ovarian teratoma and is composed entirely or predominantly of thyroid tissue and containing variable-sized follicles with colloid material. 2008;65 (2): 104-7. Struma ovarii: management and follow-up … We report a rare occurrence of coexisting struma ovarii along with a serous cystadenoma in a 55 year old woman. Despite its name, struma ovarii is not restricted to the ovary. Introduction: Struma ovarii accounts for 2% of mature teratomas. On CT scans they are most often seen as smooth marginated multicystic masses with a high attenuation on precontrast scans and no or moderate cyst wall enhancement 4. 2. Background: Malignant struma ovarii (MSO) are rare tumors that arise from ectopic thyroid tissue in the ovary, benign struma ovarii (BSO). Some of the cystic spaces may demonstrate low signal intensity on both T1- and T2-weighted images due to the thick, gelatinous colloid of the struma. Struma ovarii accounts for only 2 % of all mature teratomas, and less than 5 % of struma ovarii present malignant transformation [4, 6, 7]. Magnetic resonance imaging findings may be more characteristic: The cystic spaces demonstrate both high and low signal intensity on T1- and T2-weighted images. Cysts derived from struma ovarii may mimic a mucinous or serous cystadenoma. A 7.2-cm classical variant of PTC arising in a struma ovarii was identified in the right ovary. 1. 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. 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.) Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. 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. Struma ovarii concurrently occurring with other ovarian epithelial tumors has been rarely reported. The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. The ultrasound (US) features of struma ovarii are nonspecific, but a heterogeneous, predominantly solid mass may be seen. 5. ovarian teratomas with neural differentiation. Radiographics. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 1889;115:493–504. (1-6) It is defined as an ovarian teratoma that is composed predominantly of thyroid tissue (> 50%), or forms a … The complications of Struma Ovarii may depend on whether the tumor is benign or malignant. Two months after the pelvic surgery, total thyroidectomy was performed, and a small nodule (0.8 cm) in the left lobe was diagnosed as a classical variant of PTC. Check for errors and try again. Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. Berghella V, Ngadiman S, Rosenberg H et-al. Yoo SC, Chang KH, Lyu MO et-al. [2, 3]. Struma ovarii (SO) infrequently harbor carcinomas that are histologically similar to those arising in the eutopic thyroid. Struma ovarii accounts for only 2 % of all mature teratomas, and less than 5 % of struma ovarii present malignant trans-formation [4, 6, 7]. Matsuki M, Kaji Y, Matsuo M et-al. Struma ovarii is a rare ovarian tumour that has been reported to represent 0.5%–1.0% of all ovarian tumours. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Struma ovarii accounts for approximately 5 percent of all ovarian teratomas . Because complete TSH suppression occurs in struma ovarii, the neoplastic thyroid tissue is assumed to be functionally autonomous to cause thyrotoxicosis. Struma ovarii (SO) is a variant of dermoid tumors which completely or mainly composed of thyroid tissues. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. Struma ovarii means ovarian goiter which originates from a single germ cell after the first meiotic division [1, 2] and is the most common type of mono- dermal teratoma in 3% of mature teratomas, 0.3-1% of ovarian tumour, 5-20% of mature teratoma has the component of thyroid tissue and only 2% of these cases were diagnos- ed SO. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. 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