Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. Malignant struma ovarii. 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. 5. 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. Jung SI, Kim YJ, Lee MW et-al. Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumor, derivate from monodermic teratomas. Radiographics. It is predominantly hypoechoic with internal septa and multiple thin echogenic bands. 2008;19 (2): 135-8. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. Struma ovarii accounts for approximately 5 percent of all ovarian teratomas . 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. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. It represents 2–3% of all ovarian tumours and by definition must be comprised of at least half thyroid tissue [2–4]. 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 … The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases.[2]. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. Scintigraphy showing increased radioiodine uptake in the pelvic mass compared to the thyroid is confirmatory. Most cases of MSO are subclinical. Ascites may be present in up to a third of cases 7. 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. Struma ovarii is a rare cause of hyperthyroidism. Boettlin R. Uber zahnentwickelung in dermoid cysten des ovariums. Struma ovarii is a rare ovarian tumour that has been reported to represent 0.5%–1.0% of all ovarian tumours. J Gynecol Oncol. 1889;115:493–504. The patient exhibited menstrual disorders. The mean age at diagnosis of MSO was 43 years old [ 6, 9 ]. {"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"}. 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. Most MSO are histologically classified as papillary thyroid carcinomas (PTC). 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.) Approximately 5-8% of cases can show symptoms or signs of thyrotoxicosis. Molecular analysis of tissues obtained from both the malignant struma ovarii and thyroid gland was performed. RAS mutations both in the PTC … Iodine-123 will be taken up by any functioning thyroid tissue, and is diagnostic of struma ovarii if seen in the adnexal region. -. First described by R Boettin in 1889 7,8. Struma ovarii is a teratoma in which thyroid tissue is present exclusively or forms a grossly recognizable component of a more complex teratoma [ 8 ]. Struma ovarii: management and follow-up … 2. 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. Struma Ovarii. A suspicion of the … Imaging findings of complications and unusual manifestations of ovarian teratomas. PMID: 26149143. (1-6) It is defined as an ovarian teratoma that is composed predominantly of thyroid tissue (> 50%), or forms a … intracranial teratoma with malignant transformation, mediastinal non-germinomatous germ cell tumors, mediastinal teratoma with malignant transformation. Introduction. Cystic struma ovarii (with macrocystic change) By MD Christopher Otis and MD Liron Pantanowitz. Etiology. Gynecol. Obstet. Treatment is with surgical resection. Struma ovarii: CT findings. Despite its name, struma ovarii is not restricted to the ovary. In this study, we … Because complete TSH suppression occurs in struma ovarii, the neoplastic thyroid tissue is assumed to be functionally autonomous to cause thyrotoxicosis. 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. The cystic spaces can demonstrate both high and low (from gelatinous colloid 3) signal intensity on T1 and T2 weighted images. Park SB, Kim JK, Kim KR et-al. There is no internal vascularity. A struma ovarii is a rare form of monodermal teratoma that contains mostly thyroid tissue, which may cause hyperthyroidism. Malignant struma ovarii is rarer still, The rate of malignant transformation in struma ovarii is extremely low. Ce terme est réservé aux tératomes comportant de façon exclusive ou prédominante du tissu thyroïdien. Magnetic resonance imaging findings may be more characteristic: The cystic spaces demonstrate both high and low signal intensity on T1- and T2-weighted images. Les struma ovarii malins représentent 5 à 10 % de … 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 a specialized or monodermal teratoma predominantly composed of mature thyroid tissue. A clue to the diagnosis is the presence of a green to brown glairy fluid. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. 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. Discussion Le struma ovarii est un tératome mature monotissulaire rare. 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. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Struma Ovarii Clinique: * The most frequently symptom is abdominal pain (50 %) though a high percentage (40 %) of patients were asymptomatic (1). 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]. Sonographic and Pathologic Features of Struma Ovarii. 1997;43 (1): 68-72. 2000;73 (865): 87-90. The vast majority of struma ovarii tumors (90-95% 1,5) tend to be benign and therefore carry a good prognosis. [2, 3]. We discuss the approaches leading to the correct diagnosis and we review the management of the disease. Struma ovarii is rare; less than 200 cases have been reported in the medical literature [3, 5]. We report a rare occurrence of coexisting struma ovarii along with a serous cystadenoma in a 55 year old woman. Struma ovarii is a rare type of mature teratoma, but its imaging features are rather distinct. 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. Introduction: Struma ovarii accounts for 2% of mature teratomas. May be seen as a multiloculated cystic mass, with solid parts. We identified 10 such cases in our files. Struma ovarii accounts for approximately 5 percent of all ovarian teratomas [2-4]. Hatami M, Breining D, Owers RL et-al. Check for errors and try again. Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. Struma ovarii (SO) infrequently harbor carcinomas that are histologically similar to those arising in the eutopic thyroid. 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 … Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. struma ovarii and these can be corroborated by nuclear medicine. Obstet. Struma ovarii accounts for only 2 % of all mature teratomas, and less than 5 % of struma ovarii present malignant transformation [4, 6, 7]. The ultrasound (US) features of struma ovarii are nonspecific, but a heterogeneous, predominantly solid mass may be seen. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. A case report and review of the literature. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. There is a slightly hyperechoic focus within the lesion which demonstrates post acoustic shadowing. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. Struma ovarii is a monodermal germ cell tumor first de-scribed by R. Boëttlin in 1889 [1]. Meigs JV. The complications of Struma Ovarii may depend on whether the tumor is benign or malignant. Virchows Arch Path Arat. Struma ovarii causes overt thyrotoxicosis only rarely, depending on the amount of follicular tissue present in the neoplasia. 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. References 1. Berghella V, Ngadiman S, Rosenberg H et-al. Cysts derived from struma ovarii may mimic a mucinous or serous cystadenoma. 3. 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. Approximately 5 percent of the tumor if seen in the right ovary tumours, 5... 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