Struma ovarii with torsion

Discussion:

Risk stratification:

Based on the IOTA simple rules, this lesion has no "B" or "M" features and is therefore inconclusive.

ADNEX model: 55% risk of malignancy (borderline most likely)

Using O-RADS, this would be classified as ORADS 4 Intermediate risk of malignancy (10-50%): Multilocular cyst with solid component, any size, color score 1-2. Recommend management by a gynae-oncologist.

Discussion:

Struma ovarii in a 12 year old girl, presenting with recurrent ovarian torsion.

Ca 125, AFP and bHCG all within normal limits.

Struma ovarii is an uncommon subtype of an ovarian teratoma containing thyroid tissue. They are benign in 90-95% of cases.

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