Cystic struma ovarii: imaging findings

Area of Science:

• Gynecologic pathology
• Ovarian neoplasms
• Endocrine pathology

Background:

• Struma ovarii is a rare germ cell tumor composed of thyroid tissue.
• It is typically found within an ovarian teratoma, often with a solid component.
• Completely cystic struma ovarii is exceptionally rare, posing diagnostic challenges.

Observation:

• The study details three cases of cystic struma ovarii lacking solid components.
• One case presented as a unilocular cystic mass with thin walls.
• Two cases were multilocular cystic masses, with specific MRI signal characteristics noted (T2 signal void, T1 intermediate intensity).

Findings:

• Preoperative diagnosis of cystic struma ovarii was challenging in all reported cases.
• The absence of a solid component can obscure the diagnosis.
• Characteristic MRI findings were observed in multilocular cystic variants.

Implications:

• Cystic struma ovarii must be included in the differential diagnosis of cystic ovarian masses.
• Radiological and pathological evaluation is crucial for accurate diagnosis.
• Awareness of this rare entity can improve patient management and outcomes.