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Fertil Steril. 2011 May;95(6):2124.e9-12. doi: 10.1016/j.fertnstert.2010.12.047. Epub 2011 Jan 26.

Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment.

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1
Department of Obstetrics and Gynecology, University Hospital for Women, and Department of Pathology, University of Tübingen, Tübingen, Germany. Bernhard.Kraemer@med.uni-tuebingen.de

Abstract

OBJECTIVE:

To report the case of a patient with malignant struma ovarii, which was excised endoscopically.

DESIGN:

Case study and literature review.

SETTING:

Hospital outpatient clinic with subsequent hospitalization.

PATIENT(S):

A 40-year-old gravida 5, para 3 with an incidental ultrasonographic finding of a solid right adnexal mass.

INTERVENTION(S):

Endoscopic resection and 1-year follow-up.

MAIN OUTCOME MEASURE(S):

Treatment options and differential diagnosis.

RESULT(S):

The tumor was excised endoscopically.

CONCLUSION(S):

Malignant struma ovarii is a very rare, highly specialized form of mature ovarian teratoma, in which thyroid tissue is the predominant element. Because of the nonspecific symptoms and a lack of specific features in imaging studies, preoperative diagnosis is very difficult, and there is no standard treatment. Struma ovarii, which is potentially malignant, should be included in the differential diagnosis of an ovarian mass with cystic, solid, or mixed cystic and solid structure. Standardized treatment of malignant struma ovarii still remains undefined; currently the laparoscopic removal of the tumor may be a treatment option, and thyroidectomy and radiotherapy with 131I should be offered.

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