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Struma ovarii tumour

Struma ovarii tumour is a subtype of an ovarian teratoma and is composed entirely or predominantly of thyroid tissue and containing variable-sized follicles with colloid material.

It accounts for 0.3-1% of all ovarian tumours and for approximately 3% of all mature cystic teratomas 1

Clinical presentation

Approximately 5-8% of cases can show symptoms or signs of thyrotoxicosis. More content required

Pathology

To qualify as a struma ovarii tumours more than 50% of tumour should be composed of thyroid tissue 7.

The gross pathologic appearance of struma ovarii differs from that of mature cystic teratomas where struma ovarii consist of amber-colored thyroid tissue, with haemorrhage, necrosis, and fibrosis.

Radiographic features

While imaging features can be non-specific with overlap with other ovarian neoplasms, ultrasound an and CT usually demonstrate a complex adnexal lesion with multiple cystic and solid areas, reflecting the gross pathologic appearance of the tumour 1.  Ascites may be present in up to a 3rd of cases 7.

CT

On CT scans they are most often seen as as smooth marginated multicystic masses with a high attenuation on precontrast scans and no or moderate cyst wall enhancement 4.

Pelvic MRI

May be seen as a multiloculated cystic mass, with solid parts. The cystic spaces can demonstrate both high and low (from gelatinous colloid 3) signal intensity on T1 and T2 weighted images. 

The presence of areas of very low signal intensity on T2-weighted images, due to viscous colloid material is sometimes considered as suggestive for the presence of struma ovarii tumour 9.

  • T1 C+ (Gd): the solid portions may show enhancement 2

Treatment and prognosis

Treatment is with surgical resection. The vast majority of struma ovarii tumours (~90-95% 1,5) tend to be benign and therefore carry a good prognosis. More content required.

History and etymology

First described in R Boettin in 1889 7-8.

See also


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