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