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