Laparoscopy with detorsion and cystectomy was performed.
Histopathology report:
Sections show ovary with a cyst lined by a single layer of cuboidal epithelium with underlying fibrotic stroma. The cyst wall is thickened with extensive haemorrhage, oedema, granulation tissue and chronic inflammation consistent with torsion. Focally within the cyst wall there are thyroidal follicular structures which contain eosinophilic material. These are lined by round bland nuclei with no features of papillary thyroid carcinoma. The follicular cells are positive with TTF-1, PAX8 and thyroglobulin. There are no features of a mature cystic teratoma. There is no evidence of malignancy. The background ovary shows multiple cystic follicles.
DIAGNOSIS:
Cystic struma ovarii with features of torsion.