Struma ovarii: role of imaging?

Area of Science:

• Gynecologic Oncology
• Radiology
• Pathology

Background:

• Struma ovarii is a rare germ cell tumor of the ovary containing thyroid tissue.
• Clinical presentation is often non-specific, mimicking ovarian malignancy.
• Thyrotoxicosis is absent in most struma ovarii cases.

Purpose of the Study:

• To review key imaging findings of benign and malignant struma ovarii.
• To highlight the role of magnetic resonance (MR) imaging in diagnosing struma ovarii.
• To present an unusual case of a purely cystic ovarian struma.

Main Methods:

• Review of existing literature on struma ovarii imaging.
• Emphasis on state-of-the-art MR techniques, including high-resolution and diffusion-weighted imaging.
• Presentation and discussion of a unique case of cystic struma ovarii.

Main Results:

• Struma ovarii can present with non-specific clinical features, similar to ovarian cancer.
• Advanced MR imaging may help characterize this rare ovarian mass.
• Purely cystic struma ovarii is an uncommon presentation.

Conclusions:

• Preoperative radiological diagnosis is crucial to avoid extensive surgery for benign struma ovarii.
• While MR imaging shows promise, its definitive role in preoperative identification of struma ovarii remains limited.
• Accurate diagnosis is essential to prevent unnecessary bilateral salpingo-oophorectomy, hysterectomy, omentectomy, and appendectomy.