Struma ovarii: two case reports of a rare teratoma of the ovary

Abstract

Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. It is usually a benign condition; however, malignant transformation is sometimes detected. The diagnosis relies on histopathological examination and is infrequently made on routine investigations. We report two cases of struma ovarii: one benign and the other malignant. The first case involved a 27-year-old woman who underwent a right ovarian cystectomy for an incidental ultrasonographic finding of a solid right adnexal mass. The diagnosis of a benign struma was made after histopathological study. The second case involved a 68-year-old woman who underwent a right salpingo-oophorectomy for a right ovarian bulky mass and the histopathological diagnosis was consistent with that of a malignant struma. We examine the challenges involved in the diagnosis and management of this rare entity.

Management of malignant struma ovarii: is aggressive therapy justified? Case report and literature review

“…In most cases, MSO is discovered incidentally during routine ultrasonography, due to the lack of specificity regarding clinical or imaging criteria [ 6 , 9 , 10 ]. Retrospective studies have shown that as much as 40% of patients are asymptomatic, the diagnosis being often delayed [ 11 , 16 ].…”

“…Struma ovarii (SO) is a rare monodermal variant of ovarian teratoma that contains predominantly thyroid tissue (> 50%), accounting for 0.5-1% of all ovarian tumors and 2-5% of ovarian teratomas [1][2][3][4]. It may present any form of thyroid pathology, and in most cases is a benign condition, but approximately 5-10% of these tumors become malignant (MSO), with papillary and follicular carcinoma most common [5,6].…”

“…MSO may be asymptomatic, usually discovered incidentally during routine ultrasound examination, and is difficult to recognize based on clinical or imaging criteria. Most cases are diagnosed after surgical removal of an ovarian cyst or mass, on histopathological examination [6][7][8][9].…”

Toxic Multi Goiter and Struma ovarii Coexistence: Report of a Rare Case

“…Only 5-8% of cases are associated with clinical hyperthyroidism. These tumors are often diagnosed incidentally after surgery (9). The thyroid gland of these patients is not enlarged, and radioiodine uptake is low or absent in their thyroid gland; however, it often accumulates in their pelvis (10,13).…”

Struma ovarii: A case report and review the literature

“…The initial footprint of the tumor is mostly based on incidental imaging, but definitive diagnosis is possible based on pathological studies. Surgical resection of the tumor followed by adjuvant radioiodine therapy has been accepted as the definitive therapeutic approach leading prevention of disease metastasis or recurrence (5). Herein, we described a case of struma ovarii that was successfully diagnosed and managed.…”