Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 312-314    DOI: 10.31083/j.ceog.2020.02.5049
Case Report Previous articles | Next articles
Successful laparoscopic tumorectomy of struma ovarii diagnosed preoperatively
H. Morita1, *(), Y. Yamasaki1, S. Sugino1, H. Koh1, N. Kojima1, K. Kitajima2, T. Yamazaki3, K. Takeuchi4
1Department of Obstetrics and Gynecology, Rokko Island Konan Hospital, Kobe, Japan
2Department of Radiology, Hyogo Medical College, Nishinomiya, Japan
3Department of Diagnostic Pathology, Konan Hospital, Kobe, Japan
4Department of Obstetrics and Gynecology, Kobe Medical Center, Kobe, Japan
Download:  PDF(17216KB)  ( 167 ) Full text   ( 7 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

Introduction: Struma ovarii is rare ovarian tumor. Almost 95% of it is indicated as the benign tumor. Therefore, it is important to be diagnosed preoperatively. A case that is diagnosed successfully as a struma ovarii preoperatively, is presented. Case Report: A 36-year-old Japanese woman G1P1, with no family history nor past history, was referred to this hospital for the treatment of an ovarian tumor, because followed up ovarian tumor gradually became enlarged. Regarding the patient’s laboratory data, no tumor marker was elevated. Thyroid function was within normal range. Ultrasound study demonstrated that the tumor was a multilocular mass with solid part. Pelvic MRI indicated stained glass appearance. Although there was a possibility of mucinous malignant tumor as a differential diagnosis, the authors mainly diagnosed it preoperatively as a struma ovarii. Laparoscopic right ovarian tumorectomy was performed and the histological examination revealed as a struma ovarii without malignancy. Conclusions: When the ovarian tumor presents a stainedglass appearance, it is important to diagnose carfeully keeping struma ovarii in mind as a differntial diagnosis.

Key words:  Struma ovarii      Laparoscopic operation      Preoperative diagnosis      Magnetic resonance imaging     
Published:  15 April 2020     
*Corresponding Author(s):  H. Morita     E-mail:  h.morita@kohnan.or.jp

Cite this article: 

H. Morita, Y. Yamasaki, S. Sugino, H. Koh, N. Kojima, K. Kitajima, T. Yamazaki, K. Takeuchi. Successful laparoscopic tumorectomy of struma ovarii diagnosed preoperatively. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 312-314.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5049     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/312

Figure 1.  — Transvaginal ultrasound examination of the case: several cysts can be seeen beside the solid part in the ovarian mass.

Table 1  — Laboratory data of the patient’s first visit.
CEA 1.2 ng/ml TSH 1.144 μU/ml
SCC 0.8 ng/ml Free T3 2.75 pg/ml
CA-125 16.0 U/ml Free T4 1.03 ng/ml
CA19-9 21.1 U/ml
Figure 2.  — Pelvic MRI of the case. A) T1WI. B) T2WI. C) Gd- Enhanced T1WI: pelvic MRI demonstrates the multilobular cystic tumor with stained glass appearance. The solid part and thickened septi of the tumor show low intensity on T2WI which is rapidly and strongly enhanced.

Figure 3.  — Laparoscopic findings: a small amount of ascites is observed. Right ovary is as large as 6 cm and adheres to retroperitoneum. A) Uterus (U) and left ovary. B) Uterus (U) and right ovary.

Figure 4.  — Resected right ovarian tumor.

Figure 5.  — Histological examination revealed as a struma ovarii without malignancy. A) Low magnification. B) High magnification.

[1] Kraemer B., Grischke E.M., Staebler A., Hirides P., Rothmund R.: “Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment”. Fertil. Steril., 2011, 95, 2124 e9.
[2] Ayhan A., Yanik F., Tuncer R., Tuncer Z.S., Ruacan S.: “Struma ovarii”. Int. J. Gynaecol. Obstet., 1993, 42, 143.
doi: 10.1016/0020-7292(93)90628-a pmid: 7901063
[3] Yoo S.C., Chang K.H., Lyu M.O., Chang S.J., Ryu H.S., Kim H.S.: “Clinical characteristics of struma ovarii”. J. Gynecol. Oncol., 2008, 19, 135.
doi: 10.3802/jgo.2008.19.2.135 pmid: 19471561
[4] Hatami M., Breining D., Owers R.L., Del Priore G., Goldberg G.L.: “Malignant struma ovarii—a case report and review of the literature”. Gynecol. Obstet. Invest., 2008, 65, 104.
doi: 10.1159/000108654 pmid: 17890867
[5] Cohen A.I., Castillo Aguilar C.E., Gomez S.B., Rodriguez M.O.: “Struma ovarii: a variety of monodermic teratoma of the ovary. Report of 8 cases”. Ginecol. Obstet. Mex., 1999, 67, 153.
pmid: 10363413
[6] Rim S.Y., Kim S.M., Choi H.S.: “Struma ovarii showing clinical characteristics of ovarian malignancy”. Int. J. Gynecol. Cancer, 2005, 15, 1156.
doi: 10.1002/1097-0142(196211/12)15:6<1156::aid-cncr2820150611>3.0.co;2-q pmid: 13952140
[7] Yassa L., Sadow P., Marqusee E.: “Malignant struma ovarii”. Nat. Clin. Pract. Endocrinol. Metab., 2008, 4, 469.
pmid: 18560398
[8] DeSimone C.P., Lele S.M., Modesitt S.C.:“Malignant struma ovarii: a case report and analysis of cases reported in the literature with focus on survival and I131 therapy”. Gynecol. Oncol., 2003, 89, 543.
doi: 10.1016/s0090-8258(03)00141-0 pmid: 12798728
[9] Savelli L., Testa A.C., Timmerman D., Paladini D., Ljungberg O., Valentin L.: “Imaging of gynecological disease (4): clinical and ultrasound characteristics of struma ovarii”. Ultrasound Obstet. Gynecol., 2008, 32, 210.
doi: 10.1002/uog.5396 pmid: 18636616
[10] Ikeuchi T., Koyama T., Tamai K., Fujimoto K., Mikami Y., Konishi I., Togashi K.: “CT and MR features of struma ovarii”. Abdom. Imaging, 2012, 37, 904.
doi: 10.1007/s00261-011-9817-7 pmid: 22052450
[1] Laura Joigneau, Yolanda Ruiz, Coral Bravo, Julia Bujan, Miguel A Ortega, Juan De León-Luis. The brainstem-tentorium angle revisited. Difficulties encountered and possible solutions[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(4): 991-994.
[2] Xiao-Hua Li, Jian-Kun Zhou, Jing-Dan Cheng. Application of ultrasound in hepatic pregnancy: a case report and literature review[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(2): 434-438.
[3] D. Matsubara, H. Takahashi, K. Kataoka, T. Minami, R. Furukawa, S. Matsubara, T. Yamagata. Tracheal stenosis due to vascular rings: its possible prenatal diagnosis based on four cases of vascular rings with or without eventual tracheal stenosis[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 828-830.
[4] Shigeo Iijima. A case of body stalk anomaly: the value of adding fetal magnetic resonance imaging to ultrasonography for perinatal management[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 930-932.
[5] P. Tsikouras, B. Manav, A. Liberis, P. Naoumis, V. Souftas, G. Galazios. Twin pregnancy in a partial septate uterus and the contribution of magnetic resonance imaging. A case report and brief literature review[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(4): 630-633.
[6] M.P. Biso, P. Sala, V.G. Vellone, G. Minetti, C.R. Gaggero, M. Foppiano, E. Fulcheri, P. De Biasio. Virtopsy in conjoined ischiopagus twins[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(2): 288-291.
[7] V. Fiaschetti, M. Fornari, V. Cama, M. Rascioni, V. Liberto, G. Sorrenti, G. Simonetti. MRI in the assessment of prolapsed pedunculated submucous leiomyomas: two case reports[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(6): 827-832.
[8] A.S. Lagana, G. Santoro, O. Triolo, V. Giacobbe, R. Certo, V. Palmara. Hashimoto thyroiditis onset after laparoscopic removal of struma ovarii: an overview to unravel a rare and intriguing finding[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(5): 673-678.
[9] V. Fiaschetti, M. Massaccesi, M. Fornari, M. Nezzo, V. Da Ros, G. Sorrenti, G. Simonetti. Isthmocele in a retroflexed uterus: a report of an unrecognized case[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(5): 705-707.
[10] F.V. Oreopulu, C. Sofoudis, S. Voulgaridou, S. Stasinopoulou, S. Fountoulis, G.P. Fragulidis. Struma ovarii complicating pregnancy: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(4): 550-552.
[11] T. Takei, S. Matsuoka, N. Ashitani, N. Makihara, M. Morizane, N. Ohara. Ruptured cornual pregnancy: case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2009, 36(2): 130-132.
[12] E. S. Saygili-Yilmaz, K. K. Incki, M. Turgut, S. Kelekci. Prenatal diagnosis of type I sacrococcygeal teratoma and its management[J]. Clinical and Experimental Obstetrics & Gynecology, 2008, 35(2): 153-155.
[13] M. G. Porpora, D. Pallante, A. Ferro, P. L. Alò, E. V. Cosmi. Asymptomatic struma ovarii: A case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2005, 32(3): 197-198.
No Suggested Reading articles found!