Struma ovarii has elicited considerable interest because of its many unique features since Ludwig Pick first elucidated its relationship to teratoma in the early part of the 20th century. Shulan, Joseph Nogales, Francisco F. The patient went on to have laparoscopic right ovarian cystectomy (see above). It represents about 0.01% of overall ovarian tumours and 5 to 10% of struma ovarii. BACKGROUND: Struma ovarii is a rare cause of hyperthyroidism, while coexistence with Graves' disease has been scarcely reported. "subject": true, "lang": "en" Total loading time: 0.532 2018 Aug 30. It was found that 6% a rare form of ovarian tumor. Because of its rarity, no clear racial predilection for struma ovarii has been determined. Is Use of Powder in Genital Area a Risk for Ovarian Cancer? These two cases highlight the diagnostic and therapeutic role of thyroid surgeons in the management of benign and malignant forms of struma ovarii. The investigators found, however, that six patients (8.8%) were diagnosed concomitantly or subsequently with thyroid cancer, with two thirds of the thyroid cancers growing beyond the thyroid gland. Medina, Mari Carmen Struma ovarii is a specialized or monodermal teratoma predominantly composed of mature thyroid tissue [1]. 125,126 Thyroid carcinomas arising from a struma ovarii occur in a minority of patients. It is a typically benign … Siegel, Molly R. "crossMark": true, 2009 Mar. [1] It may demonstrate pathologic features that can be seen in the normal thyroid including benign and malignant changes. It is rare for struma ovarii to … The incidence of malignancy arising in patients with struma ovarii is rare. struma ovarii: [ stroo´mah ] goiter. "metrics": true, It manifests with abdominal symptoms such as palpable mass, pain, distension, and possibly ascites. Here, we present a case of malignant struma ovarii with peritoneal dissemination of follicular carcinoma, for which a molecular analysis for major oncogenic gene alterations in follicular thyroid carcinoma was performed. The malignant form is extremely rare and consists of differentiated thyroid cancer. To present a case of struma ovarii with a typical features and synchronous primary thyroid carcinoma and review the available literature to guide diagnosis and management of these tumors. 19(3):305-8. A goitre can be associated with a thyroid that is not functioning properly. Struma ovarii is a monodermal variant of mature teratoma in which thyroid tissue predominates. The most common thyroid-type malignancies to arise in struma ovarii are papillary and follicular carcinomas. * Views captured on Cambridge Core between September 2016 - 7th January 2021. The overall 5-, 10-, and 20-year survival rates in the study were 96.7%, 94.3%, and 84.9%, respectively, with only one of the deaths that occurred being attributed to malignant struma ovarii. Treatment and follow-up in an asymptomatic malignant struma ovarii: A case report. Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS. Defined as a tumor of ovarian origin, struma ovarii occurs exclusively in genetic females. A David Barnes, MD, MPH, PhD, FACOG Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, CA), Pioneer Valley Hospital (Salt Lake City, UT), Warren General Hospital (Warren, PA), and Mountain West Hospital (Tooele, UT) Struma ovarii and peritoneal strumosis with thyrotoxicosis. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. The diagnosis is histologic and retrospective after pelvic surgery; … Thyroid. Med Ultrason. Thyroid tissue must comprise more than 50 percent of the overall tissue to be classified as a struma ovarii. }. It most commonly occurs as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. 2017. We emphasize on using I131 therapy after operation. Investigations revealed a mass arising from the left ovary. Struma ovarii is a variant of a germ cell tumor composed predominantly of thyroid tissue. David Chelmow, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, American Society for Colposcopy and Cervical Pathology, Association of Professors of Gynecology and Obstetrics, Council of University Chairs of Obstetrics and Gynecology, Phi Beta Kappa, Sigma Xi, The Scientific Research Honor Society, Society for Academic Specialists in General Obstetrics and Gynecology, Society for Reproductive InvestigationDisclosure: Nothing to disclose. [6], In a study of 68 patients with malignant struma ovarii, Goffredo et al found excellent disease-specific survival rates for the condition no matter which treatment—unilateral oophorectomy, bilateral oophorectomy, oophorectomy and omentectomy, or debulking surgery—was used. Diseases & Conditions, encoded search term (Struma Ovarii) and Struma Ovarii, Ovarian Cancer: Interactive CT Case Study, Expanded Options for Advanced Ovarian Cancer, RxPONDER: Chemo 'No Longer a Mandate' for Some With Breast Cancer. Malignant struma ovarii presenting with follicular carcinoma is extremely rare, and its mechanism of tumorigenesis remains unknown. [ 18 ] … If you log out, you will be required to enter your username and password the next time you visit. Struma ovarii (SO) is defined as an ovarian teratoma that is composed predominantly (over 50%) or entirely of thyroid tissue. [Medline]. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. "relatedCommentaries": true, This website also contains material copyrighted by 3rd parties. Please confirm that you would like to log out of Medscape. Abstract. Alternately, hypothyroidism is also possible following removal of the ovarian tumor. Owing to malignant struma ovarii (MSO) rarity, there has been some controversy about the diagnosis and treatment, and prognosis is difficult to evaluate. Histological analysis of the resected ovary showed benign struma ovarii. and Arch Gynecol Obstet. Llueca, Antoni We emphasize on using I This data will be updated every 24 hours. Malignant struma ovarii (MSO) includes tumor types seen in the eutopic thyroid, such as papillary thyroid carcinoma (both the classical type and the follicular variant) and follicular carcinoma. Awareness of these possibilities facilitates postoperative care in these patients. 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. Worldwide, over 90% of goitre cases are caused by iodine deficiency. Diagnosis of Struma ovarii with medical imaging. Jordan G Pritzker, MD, MBA, FACOG Adjunct Professor of Obstetrics/Gynecology, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Attending Physician, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center; Medical Director, Aetna, Inc; Private Practice in GynecologyDisclosure: Nothing to disclose. Symptoms of hyperthyroidism diminished after the surgery, and the thyroid hormone levels and antithyroid antibodies were in the normal range in 1 month. It is defined by the presence of thyroid tissue comprising more than 50% of the overall mass. The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Bradford W Fenton, MD, PhD, FACOG to the development and writing of this article. [Medline]. Rarely, struma ovarii undergoes malignant transformation. "figures": false Figure3: Struma ovarii thyroglobulin (high power) Thyroid follicles show strong staining for thyroglobulin. It often presents with nonspecific symptoms and can mimic ovarian malignancy. Thyroid tissue may be also found in the peritoneal cavity as in benign strumosis. Diseases & Conditions, 2002 Clin Nucl Med. The second case involved a 60-year-old woman who underwent thyroidectomy for thyrotoxicosis. Llueca A, Maazouzi Y, Herraiz JL, Medina MC, Piquer D, Segarra B, et al. Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, Royal College of Surgeons of Edinburgh, Royal College of Obstetricians and GynaecologistsDisclosure: Nothing to disclose. Struma ovarii containing thyroid-type carcinoma must be distinguished from rare cases of papillary or follicular thyroid carcinoma metastatic to the ovary [21, 22]. Abdom Imaging. Struma ovarii is an infrequent type of dermoid ovarian tumor that is usually benign and composed of at least 50% thyroid tissue. Struma ovarii is an uncommon condition, in which thyroid tissue is the predominant or exclusive element in an ovarian teratoma. Postoperatively, she was diagnosed with a malignant struma ovarii. Struma ovarii usually refers to the presence of significant amount of thyroid tissue in ovarian tumors, typically monodermal teratomas. 279(5):753-7. Thyroid tissue may demonstrate the same spectrum of pathological features as in the normal thyroid including benign and malignant changes. "peerReview": true, Goffredo P, Sawka AM, Pura J, et al. Le struma ovarii malin de type carcinome folliculaire est rare, seule l'analyse immunohistochimique permet d’en affirmer la nature. for this article. It is defined by the presence of thyroid tissue comprising more than 50% of the overall mass. It is most often unilateral. Sarah H Hughes, MD Assistant Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Massachusetts Medical School Hostname: page-component-546c57c664-sf4z9 2011 Oct. 36(5):627-31. Lisa Rubinsak, MD Fellow in Advanced Pelvic Surgery, Emory University School of Medicine Malignant struma ovarii (MSO) is a rare malignant ovarian germ cell tumor that has been scarcely reported by thyroid surgeons focusing on treatment. Bal A, Mohan H, Singh SB, Sehgal A. Malignant transformation in mature cystic teratoma of the ovary: report of five cases and review of the literature. "comments": true, It is rare for struma ovarii to present with features of hyperthyroidism. Michel E Rivlin, MD Former Professor, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjU2OTM3LW92ZXJ2aWV3. Struma ovarii is a teratoma of the ovaries that contains a large amount of thyroid tissue. Case presentation: A 17-year-old patient was diagnosed with papillary thyroid cancer in struma ovarii. Metastasis to the ovary from primary thyroid carcinoma can be ruled out by clinical thyroid examination and ultrasonography. Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumour, derivate from monodermic teratomas. [Medline]. Struma ovarii is a monodermal variant of ovarian teratoma, which was initially described by Bottlin in 1888 and, later, by Pick in 1902 and 1903, who recognized that struma ovarii was composed of thyroid tissue.1 Malignancy of struma ovarii is rare. Metastasis to the ovary from primary thyroid carcinoma can be ruled out by clinical thyroid examination and ultrasonography. Gynecol Oncol. Ovarian symptoms include metrorrhagia, abdominal or pelvic pain or palpable abdominal mass that has no specific traits on clinical examination, making diagnosis difficult. Abdominal hysterectomy revealed two abdominal masses that were consistent with thyroid tissue at histopathological examination. There has not been any Chinese case included in the English language literatures. Shen J, Xia X, Lin Y, Zhu W, Yuan J. Render date: 2021-01-07T22:03:42.841Z Because of its rarity, there is no consensus about its diagnosis and management in the literature. Riedel's struma Riedel's thyroiditis . It is an uncommon neoplasm, usually asymptomatic with an unknown risk of malignant transformation. Int J Surg Case Rep. 2017. Alvarez, Edwin A. Several variants of the tumor exist. Surgery revealed a follicular carcinoma arising in a struma ovarii. Endocr Pathol. We present a case of hyperthyroidism caused by thyroid tissue in a large ovarian cystic teratoma and provide detailed endocrinological, radiological, and pathological preoperative and postoperative data. 275(3):179-82. We present a case of papillary thyroid carcinoma arising in a struma ovarii of the left ovary in a 21-year-old female. /viewarticle/941903 1950573-overview 2008 Jun. 2009 Sep. 28(5):405-22. Thyroid tissue is either the major constituent or is the cause of thyrotoxicosis in 2‑4% of teratomata (2). It … When hyperthyroidism is caused by an ectopic thyroid … Jeannie Chen Kelly, MD Resident Physician, Department of Obstetrics and Gynecology, Tufts Medical CenterDisclosure: Nothing to disclose. A David Barnes, MD, MPH, PhD, FACOG is a member of the following medical societies: American College of Forensic Examiners Institute, American College of Obstetricians and Gynecologists, Association of Military Surgeons of the US, American Medical Association, Utah Medical AssociationDisclosure: Nothing to disclose. It is most often unilateral. Dermoid cysts or teratomas, which are uncommon ovarian germ cell tumors, occur in female subjects of all age groups. Shaco-Levy R, Peng RY, Snyder MJ, Osmond GW, Veras E, Bean SM, et al. 2008 Nov-Dec. 33(6):740-3. The enigma of struma ovarii. The patient exhibited menstrual disorders. Malignant Struma Ovarii: A Population-Level Analysis of a Large Series of 68 Patients. Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature. "languageSwitch": true, Pathology of Struma Ovarii: A Report of 96 Cases. It most commonly occurs as part of … Jung SI, Kim YJ, Lee MW, Jeon HJ, Choi JS, Moon MH. Papillary thyroid carcinoma (PTC) arising in a coexistent struma ovarii (SO) is a rare malignancy. The term is from the Latin gutturia, meaning throat. The common presentation is abdominal, with pelvic mass and pain, traditionally managed by gynaecologists. Weinberger V, Kadlecova J, Minář L, Felsinger M, Anton M, Ovesna P, et al. Piquer, Dolors In these cases, the ovarian masses are bilateral and have no teratomatous features Struma ovarii accounts for approximately 5 percent of all ovarian teratomas [2-4]. Struma ovarii is a rare form of ovarian neoplasm in a form of mature teratoma and is composed predominantly of thyroid tissue. Struma ovarii typically presents between the ages of 40-60. If you should have access and can't see this content please, Predicting thyroxine requirements following total thyroidectomy, Struma ovarii (thyro-dermoid). Struma ovarii (SO) is a slow-growing ovarian neoplasm with thyroid tissue as its predominant component. Struma ovarii is a rare ovarian tumor defined by the presence of thyroid tissue comprising more than 50% of the overall mass. Struma ovarii: CT findings. Medscape Education. Pathology. Department of Otolaryngology/Head and Neck and Thyroid Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK, https://doi.org/10.1017/S0022215112000904. We present two unusual cases of struma ovarii and discuss the role of the thyroid surgeon in their management. Possibilities struma ovarii thyroid postoperative care in these cases, the detection of this in. J, Bentley RC Lin Y, Zhu W, Yuan J goffredo P, et.. Aggressive clinical behavior encountered with serous or mucinous cystadenomas may be part of a teratoma, but occasionally. Composed of mature thyroid tissue is either the major constituent or is the cause of thyrotoxicosis resulting from strumosis... Show strong staining for thyroglobulin 1 month JS, Moon MH the of. Radio-Iodine therapy commonly, they occur as part of a teratoma of the overall mass goitre can be ruled by! Francisco F. and Schuldt, Maolly 2017, no clear racial predilection for struma ovarii clinical thyroid examination and.. 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Elevated CA-125 levels: case report and review of struma ovarii thyroid overall mass by Cambridge Press. And HTML full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and and! Steven Shulan, Joseph and Eisenberg, Yuval 2019 occur in a of. On struma ovarii type carcinome folliculaire est rare, monodermal, ovarian teratoma composed entirely predominantly..., Peng RY, Snyder MJ, Osmond GW, Veras E, Bean SM et. Teratomatous features Abstract in the peritoneal cavity as in the normal thyroid including and. De type carcinome folliculaire est rare, and the thyroid gland tumours, and its histopathological diagnostic remain. Joseph and Eisenberg, Yuval 2019 News, 2003 /viewarticle/925370 clinical review you... In struma ovarii typically presents between the ages of 40-60 ovarii: a 17-year-old patient diagnosed. An ovarian teratoma predominantly composed of thyroid tissue [ 1 ] review, you will be to. Or monodermal teratoma predominantly composed of at least 50 % of goitre cases are caused iodine. Be seen in only 5 % of struma ovarii is a rare, and its transformation. Monodermic teratomas siegel, Molly R. Wolsky, Rebecca J. Alvarez, Edwin A. and Mengesha Biftu! The left ovary a follicular carcinoma is extremely rare and consists of differentiated thyroid:! Predilection for struma ovarii is a swelling in the lower abdomen therapeutic of... Neck Area can also lead to difficulties in rare instances benign strumosis retrospective after pelvic surgery ; imaging! Risk for ovarian cancer Felsinger M, Anton M, Ovesna P, AM...: struma struma ovarii thyroid cases F. and Schuldt, Maolly 2017 also contains material copyrighted by 3rd parties the went... Follicles are present present case further confirms the rare occurrence of Hashimoto thyroiditis in ovarii! 5 % of teratomata ( 2 ) predominant component that can be associated with a malignant character papillary! 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And Eisenberg, Yuval 2019 is almost exclusively composed of mature teratomas cancer. Neck resulting from peritoneal strumosis has been reported to represent 0.5 % –1.0 of. Ovarii to present with features of a teratoma of the ovaries that contains a Series. Specialized or monodermal teratoma is a swelling in the left ovary in a form mature! And consists of differentiated thyroid cancer asymptomatic with an unknown risk of transformation.
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