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Monday, May 30, 2011

Struma Ovarii ...

          Struma Ovarii is the condition in women where , there is presence of a thyroid like tissue ,as a major cellular component in the women’s ovary as ovarian tumour , mostly a teratoma. Among the types of ovarian tumors, the proportion of teratomas ranges widely from 1 – 15 %. Struma Ovarii most commonly occurs between the ages of 45 - 65 years. Women suffering from struma ovarii usually have a pelvic mass, or associated with less frequent hyperthyroidism or ascites.
Struma Ovarii can be defined as , an ovarian tumor in a woman that contains thyroid tissue as its predominant cell types, is termed as struma ovarii. Though it typically occurs as a part of a teratoma, occasionally it may also be encountered with mucinous cystadenomas or serous. , hence the final diagnosis depends on the histo pathological examination of the mass.


Even if malignant transformation of this ovarian tumor is rare, it is mostly defined on histological criteria. Benign struma ovarii is a rare type of thyroid tissue implants throughout the peritoneal cavity. Strumal carcinoid or malignant Struma Ovarii can be defined by the presence of carcinoid tissue within a struma, which is exceptionally a rare case.


A case report of Struma Ovarii is being presented herewith –


       Mrs. J., 21 years old, female was admitted for the complaint of failure to conceive , gradually increasing painless swelling in lower abdomen with excessive , irregular and painful periods since 9 months. Previous cycles were normal .Her general condition was good ,there was no clinical evidence of thyrotoxicosis . Thyroid glands was not enlarged.


On abdominal examination ,a mass was palpable in the lower abdomen about 7 x 6 cm. in size, oval in shape , cystic in consistency and having considerable mobility.


On bimanual examination the External Os was closed , uterus was anteverted , anteflexed , smaller than normal size , mobile.A cystic mass of about 7 x 6 cm. was palpable through the posterior fornix separate from the uterus. Routine laboratory investigations did not reveal any abnormality.
On Laparotomy ,a cyst was found arising from right ovary ,measuring 6 x 7 cm. in size , the surface was greyish blue and lobulated .Fallopian tube of this side was stretched over it and was adherent to the mass. Left ovary was normal .Right sided salpingo - oophorectomy was done.
     On cutting open the tumour ,it was multi-locular containing filled with straw colored ,watery fluid .On microscopic examination thyroid tissue constituted the predominant elements in all the sections. It was in the form of acinii having flattened epithelium with or without reddish pink colloidal material.
The post-operative period was uneventful and patient discharge in satisfactory condition.

- Published in J.of Obst. & Gynae. Of India: 34(1),180.,1984



9 comments:

  1. Dr. Raghav, I have full doubdt about your capacity., for working. A nice blog along with a literature for STRUMA OVARII and hysto pathological photo is very rare to find, as the tumor is.
    Thanks

    ReplyDelete
  2. Dr. Mukesh, a nice blog with the content ,which are useful for the faculty of obstetricians and Gynaecologist. Words are too frails to express your gratitude.
    An asset for the faculty.

    ReplyDelete
  3. Dr. (Smt) sandhya GuptaMay 30, 2011 at 11:03 PM

    Dr. Raghav, I am greatful to you for providing contents regarding Struma Ovarii, full information as desired by me, have been received by me.
    Thanks.

    ReplyDelete
  4. dr.saheb aapko v aapke kaam ko naman ovary m cyst ka 2 mahilayon elaz karane m safal ho chuka hun vo bhi bina opretion ke,aapke es chitr-lekh se mujhe kafi jankari mili sadhuwad

    ReplyDelete
  5. DR. NAMARTA TADAMay 31, 2011 at 7:57 PM

    RESPECTED SIR, I HAVE GONE THROUGH ALL THE BLOGS. I HAVE PASSED MY MBBS FROM DELHI AND AFTER MARRIAGE , I AM AT BIKANER , PLEASE GIVE YOUR CELL NUMBER SO THAT , I CAN CONSULT YOU.
    WHAT EVER THE TIME SUITS YOU , I WILL MAKE A CALL OR TRY TO REACH AT YOUR PLACE.
    REGARDS.

    ReplyDelete
  6. Dr. (Smt. ) Meeta SangiMay 31, 2011 at 8:57 PM

    Dear Dr. Raghav,M., I feel to see your blog, what a beauty along with nice photo of STRUMA OVARII, and a detailed report.
    I seek your permission for publication of this report in our forth coming book.
    Please do a favour.
    Regards

    ReplyDelete
  7. Respected Prof.Tindall,Kokila ben,Smt. Sandhya Ji, Dr. Joga Singh Ji, Dr. Namarta and Dr. Meeta Sangi , thanks for viewing the blog and commenting.
    Your comments are encouraging for me.
    THANKING YOU ONCE AGAIN

    ReplyDelete
  8. Smt. Avantika PathakJune 8, 2011 at 7:18 PM

    Dr. Raghav Ji , you have given a detailed information regarding Lymphoma of ovaries. This and other article are beneficial for general women , why you do not have a blog in hindi, so that , women in general can take benefit of this all.
    Regards

    ReplyDelete
  9. Dr. Minali SaxenaJune 30, 2011 at 1:31 PM

    Struma Ovarii a rarest tumour, the diagnosis confirmed by HPR has fully been described by Dr. Mukesh Raghav.
    An article published in one journal also, worth publishing....!

    ReplyDelete