Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. 5. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - 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. [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. 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. 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]. intracranial teratoma with malignant transformation, mediastinal non-germinomatous germ cell tumors, mediastinal teratoma with malignant transformation. 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.) 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. {"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"}. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. It is defined by the presence of thyroid tissue comprising more than 50% of the … Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. (1-6) It is defined as an ovarian teratoma that is composed predominantly of thyroid tissue (> 50%), or forms a … Radiographics. Struma ovarii is a rare teratoma of the ovary that may contain functional thyroid follicular tissue, among others. A suspicion of the … Struma ovarii accounts for only 2 % of all mature teratomas, and less than 5 % of struma ovarii present malignant transformation [4, 6, 7]. It represents 2–3% of all ovarian tumours and by definition must be comprised of at least half thyroid tissue [2–4]. Struma ovarii: management and follow-up … Case presentation: A 17-year-old patient was diagnosed with papillary thyroid cancer in struma ovarii. By definition, at least 50% of the tumor mass must be represented by thyroid tissue (3). Despite its name, struma ovarii is not restricted to the ovary. Owing to malignant struma ovarii (MSO) rarity, there has been some controversy about Struma ovarii (SO) infrequently harbor carcinomas that are histologically similar to those arising in the eutopic thyroid. 2000;73 (865): 87-90. Struma Ovarii. Obstet. Struma ovarii is a teratoma in which thyroid tissue is present exclusively or forms a grossly recognizable component of a more complex teratoma [ 8 ]. Matsuki M, Kaji Y, Matsuo M et-al. PMID: 26149143. 28 (4): 969-83. Discussion Le struma ovarii est un tératome mature monotissulaire rare. RAS mutations both in the PTC … Sonographic and Pathologic Features of Struma Ovarii. Park SB, Kim JK, Kim KR et-al. 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. Check for errors and try again. Struma ovarii is an uncommon type of teratomas, difficult to identify without histopathological examination. 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. The rate of malignant transformation in struma ovarii is extremely low. 8. Malignant struma ovarii--a case report and review of the literature. Most MSO are histologically classified as papillary thyroid carcinomas (PTC). 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. First described by R Boettin in 1889 7,8. Struma ovarii accounts for only 2 % of all mature teratomas, and less than 5 % of struma ovarii present malignant trans-formation [4, 6, 7]. A 7.2-cm classical variant of PTC arising in a struma ovarii was identified in the right ovary. Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumor, derivate from monodermic teratomas. Struma ovarii occurs in patients with a substantially higher average age than for those with common mature teratomas. Despite its name, struma ovarii is not restricted to the ovary. Invest. A careful examination for any thyroid microfollicles within fibrous septa or areas of solid stroma is key. Malignant struma ovarii. J Gynecol Oncol. 33 (6): 740-3. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. Radiographics. Benign Struma Ovarii; Malignant Struma Ovarii; Recent clinical studies. Ascites may be present in up to a third of cases 7. Malignant struma ovarii is rarer still, The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases. Cystic struma ovarii (with macrocystic change) By MD Christopher Otis and MD Liron Pantanowitz. Les struma ovarii malins représentent 5 à 10 % de … and II Clinic (Professor Paavo Vara, M.D.) 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. Jung SE, Lee JM, Rha SE et-al. 6. A clue to the diagnosis is the presence of a green to brown glairy fluid. Etiology. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. Background: Malignant struma ovarii (MSO) are rare tumors that arise from ectopic thyroid tissue in the ovary, benign struma ovarii (BSO). Struma ovarii accounts for approximately 5 percent of all ovarian teratomas [2-4]. 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]. We identified 10 such cases in our files. 1997;43 (1): 68-72. Imaging findings of complications and unusual manifestations of ovarian teratomas. 2. 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. Unable to process the form. It accounts for 0.3-1% of all ovarian tumors and ~3% of all mature cystic teratomas 1. Struma ovarii is a specialized or monodermal teratoma predominantly composed of mature thyroid tissue . 2008;65 (2): 104-7. Introduction: Struma ovarii accounts for 2% of mature teratomas. Struma ovarii is difficult to diagnose and physical examination often does not reveal any abnormalities. Struma ovarii causes overt thyrotoxicosis only rarely, depending on the amount of follicular tissue present in the neoplasia. Berghella V, Ngadiman S, Rosenberg H et-al. Struma ovarii is rare; less than 200 cases have been reported in the medical literature [3, 5]. 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. The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. The cystic spaces can demonstrate both high and low (from gelatinous colloid 3) signal intensity on T1 and T2 weighted images. We discuss the approaches leading to the correct diagnosis and we review the management of the disease. 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 mean age at diagnosis of MSO was 43 years old [ 6, 9 ]. Yoo SC, Chang KH, Lyu MO et-al. Approximately 5-8% of cases can show symptoms or signs of thyrotoxicosis. 22 (6): 1305-25. Clinique: * The most frequently symptom is abdominal pain (50 %) though a high percentage (40 %) of patients were asymptomatic (1). Abstract. Hatami M, Breining D, Owers RL et-al. US demonstrates a complex appearance with multiple cystic and solid areas, findings that reflect the gross pathologic appearance of the tumor. To qualify as a struma ovarii tumors more than 50% of the tumor should be composed of thyroid tissue 7. Struma ovarii is a monodermal germ cell tumor first de-scribed by R. Boëttlin in 1889 [1]. The tumor may present as a large abdominal mass, which can be palpable on examination depending upon size and location. Struma ovarii is ectopic thyroid tissue associated with dermoid tumors or ovarian teratomas that can secrete excessive amounts of thyroid hormone and produce thyrotoxicosis. Abdom Imaging. * A struma always occurs as a pelvic mass, which may be palpable on physical examination, depending upon size and location. 3. Meigs JV. 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. Struma ovarii (SO) is a variant of dermoid tumors which completely or mainly composed of thyroid tissues. 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. 4. Molecular analysis of tissues obtained from both the malignant struma ovarii and thyroid gland was performed. [2, 3]. The complications of Struma Ovarii may depend on whether the tumor is benign or malignant. The vast majority of struma ovarii tumors (90-95% 1,5) tend to be benign and therefore carry a good prognosis. 7. May be seen as a multiloculated cystic mass, with solid parts. Introduction. Cysts derived from struma ovarii may mimic a mucinous or serous cystadenoma. Struma ovarii is a rare ovarian tumor that was first described in 1899. Struma ovarii is diagnosed when thyroid tissue comprises more than 50 % of the teratoma [4, 5]. 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. What are the possible Complications of Struma Ovarii? 1889;115:493–504. No fat is evident in these lesions. Scintigraphy showing increased radioiodine uptake in the pelvic mass compared to the thyroid is confirmatory. The vast majority of struma ovarii are benign tumours; however, malignant tumours of this type are found in a small percentage of cases.[2]. Struma ovarii is a specialized or monodermal teratoma predominantly composed of mature thyroid tissue. Struma ovarii: MRI findings. Treatment is with surgical resection. It is predominantly hypoechoic with internal septa and multiple thin echogenic bands. Concomitant struma ovarii and serous cystadenoma has been mentioned in only two case reports in the extensively searched medical literature. Obstet. Boettlin R. Uber zahnentwickelung in dermoid cysten des ovariums. Gynecol. Patients may also experience expanding abdominal growth and a fluid wave consistent with ascites. There is no internal vascularity. We report a rare occurrence of coexisting struma ovarii along with a serous cystadenoma in a 55 year old woman. ovarian teratomas with neural differentiation. Jung SI, Kim YJ, Lee MW et-al. The patient exhibited menstrual disorders. 2008;19 (2): 135-8. 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. Magnetic resonance imaging findings may be more characteristic: The cystic spaces demonstrate both high and low signal intensity on T1- and T2-weighted images. There is a slightly hyperechoic focus within the lesion which demonstrates post acoustic shadowing. References 1. In this article, a case of cystic struma ovarii with macrocystic change is presented. -. 1. Struma ovarii concurrently occurring with other ovarian epithelial tumors has been rarely reported. Br J Radiol. Because complete TSH suppression occurs in struma ovarii, the neoplastic thyroid tissue is assumed to be functionally autonomous to cause thyrotoxicosis. It represents about 0.01% of overall ovarian tumours, and 5 to 10% of struma ovarii. Struma ovarii is a rare ovarian tumor comprising less than 2% of ovarian teratomas (1), with only 5% of these being malignant tumors (2). Gynecol. Struma ovarii accounts for approximately 5 percent of all ovarian teratomas . Clinical characteristics of struma ovarii. The diagnosis is histologic and retrospective after pelvic surgery. struma ovarii and these can be corroborated by nuclear medicine. Invest. Struma ovarii is a rare type of mature teratoma, but its imaging features are rather distinct. 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. Virchows Arch Path Arat. Most cases of MSO are subclinical. In this study, we … The ultrasound (US) features of struma ovarii are nonspecific, but a heterogeneous, predominantly solid mass may be seen. A case report and review of the literature. A struma ovarii is a rare form of monodermal teratoma that contains mostly thyroid tissue, which may cause hyperthyroidism. Struma ovarii is a rare cause of hyperthyroidism. Struma ovarii: CT findings. Malignant transformation is rare, occurring in <5% of struma ovarii cases. Iodine-123 will be taken up by any functioning thyroid tissue, and is diagnostic of struma ovarii if seen in the adnexal region. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 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 is a rare ovarian tumour that has been reported to represent 0.5%–1.0% of all ovarian tumours. * Pleural effusion and … Ce terme est réservé aux tératomes comportant de façon exclusive ou prédominante du tissu thyroïdien. A complex cystic lesion within the right adnexal region, which measures 57 x 55 x 46 mm (volume 75 mL). 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. 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. The management of the overall tissue to be classified as a multiloculated mass... 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