Struma Ovarii

A rare teratoid tumor of the ovary composed almost entirely of thyroid tissue, with large follicles containing abundant colloid. Occasionally there are symptoms of hyperthyroidism. 5-10% of struma ovarii become malignant, the only absolute criterion for which is the presence of metastasis. (Dorland, 27th ed; Segen, Dictionary of Modern Medicine, 1992)

Networked: 167 relevant articles (6 outcomes, 7 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neoplasm Metastasis (Metastasis)
2.	Thyroid Neoplasms (Thyroid Cancer)
3.	Lymphatic Metastasis
4.	Neoplasms (Cancer)
5.	Papillary Thyroid Cancer

Experts

1.	Young, Robert H: 3 articles (10/2010 - 02/2005)
2.	Kamataki, Akihisa: 2 articles (01/2021 - 08/2018)
3.	Kato, Noriko: 2 articles (01/2021 - 08/2018)
4.	Menias, Christine O: 2 articles (07/2019 - 07/2010)
5.	Abu-Sini, Hosam: 1 article (11/2022)
6.	Billan, Salem: 1 article (11/2022)
7.	Taha, Tarek: 1 article (11/2022)
8.	King, Cara: 1 article (10/2022)
9.	Luna Russo, Miguel: 1 article (10/2022)
10.	Orlando, Megan S: 1 article (10/2022)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Struma Ovarii:

1.	Colloids (Colloid)IBA 04/01/2020 - "In addition, intraoperative imprint cytology revealing colloid with cracking artifact is helpful for differentiating struma ovarii and/or HDFCO from other ovarian lesions." 03/01/2004 - "Struma ovarii (4 cases) revealed colloid, both macro- and microscopically. " 03/01/1997 - "The characteristic MR appearance of struma ovarii is thought to be a mixed mass composed of T2-hyperintense solid components with intense contrast enhancement and multiple T1-hyperintense cystic areas suggestive of hemorrhagic degeneration and viscous proteinaceous colloid." 01/15/1983 - "Characteristic ultrastructural features of malignant struma ovarii are: microvilli on the surface and in the cytoplasmatic vacuoles; oncocytic transformation of cytoplasm of some cells; and presence of electron dense, granular and crystalline material (colloid) in the follicles and vacuoles. " 05/01/2023 - "The tumor did not typically show characteristic imaging findings of struma ovarii; however, the findings implied colloids of thyroid tissue within solid components on the magnetic resonance imaging (MRI) and computed tomography. "
2.	Hormones (Hormone)IBA 03/13/2020 - "We believe this is the first description of a Struma Ovarii exclusively secreting T3 hormone characterised by the paradoxical rise of a low FT4 to normal with treatment. " 09/01/2001 - "Thus, she was diagnosed preoperatively as having a hormone-producing malignant struma ovarii. " 01/01/2016 - "Within these tumors, there were 60 hormone-secreting ovarian tumors, including: 20 granulosa cell tumors, 28 fibrothecomas, 10 dysgerminomas, 2 struma ovarii, and 9 metastatic ovarian tumors. " 03/13/2020 - "Carbimazole is effective in the treatment of extrathyroidal autonomous T3 hormone production from a Struma Ovarii. " 01/01/1979 - "Discordant results (increased serum hormone levels and a low RAI) are found either in the usual forms of hyperthyroidism when large quantities of iodide are ingested, or in atypical forms of hyperthyroidism, including spontaneously resolving hyperthyroidism of subacute thyroiditis, thyrotoxicosis factitia, toxic struma ovarii, and functioning metastatic thyroid cancer. "
3.	CarbimazoleIBA 03/13/2020 - "Carbimazole is effective in the treatment of extrathyroidal autonomous T3 hormone production from a Struma Ovarii. "
4.	Proteins (Proteins, Gene)FDA Link 04/01/1965 - "STUDIES OF THE DISTRIBUTION OF IODINE AND PROTEIN IN A STRUMA OVARII." 08/01/2007 - "The distinction from clear cell carcinoma depends on awareness of this unusual variant of endometrioid neoplasia and a lack of the distinctive patterns of clear cell carcinoma; at this time, special studies, including immunohistochemistry, do not aid significantly although certainly negative reactions, such as for thyroglobulin protein (arguing against clear cell struma ovarii) may play a role in some differential diagnostic considerations. "
5.	ThyroglobulinFDA Link 01/01/2021 - "We present the case of a 56-year-old woman who was diagnosed with both a primary and recurrent struma ovarii while investigating the incidental finding of elevated blood laboratory levels of the thyroglobulin (Tg)." 01/01/2021 - "Recurrent Struma Ovarii Presented with High Levels of Thyroglobulin." 01/01/2013 - "Laboratory examination revealed elevated serum thyroglobulin, which led to the diagnosis of struma ovarii. " 12/01/2005 - "RET/PTC3 rearrangement and thyroid differentiation gene analysis in a struma ovarii fortuitously revealed by elevated serum thyroglobulin concentration." 09/01/2004 - "We recommend follow-up with surveillance thyroglobulin levels in cases of malignant Struma Ovarii for at least 10 years."
6.	IodineIBA 02/14/2020 - "Malignant struma ovarii with a robust response to radioactive iodine." 12/01/2006 - "Metastatic struma ovarii: late presentation, unusual features and multiple radioactive iodine treatments." 01/01/2022 - "Proposed Risk Stratification and Patterns of Radioactive Iodine Therapy in Malignant Struma Ovarii." 06/01/2022 - "The majority of patients with metastatic struma ovarii were treated with pelvic surgery, total thyroidectomy and radioactive iodine therapy. " 08/01/2020 - "The case of malignant Struma Ovarii of the 50-year-old woman, which led to total thyroidectomy and radioactive iodine therapy - is described."
7.	AntibodiesIBA 01/01/2015 - "The patients with struma ovarii generally do not manifest symptoms related to thyroid hyperfunction, reported only in 8% of the cases, and due to hyperstimulation of the thyroid by auto-antibodies. " 04/15/2021 - "Resolution of hyperthyroidism and thyroid antibodies following struma ovarii resection: an uncommon entity." 03/01/2002 - "This paper reports the first clinical case of a patient with Hashimoto's thyroiditis in a pure struma ovarii associated with positive specific antithyroid antibodies in the absence of symptoms and signs due to thyroid disease." 08/01/2006 - "Circulating TSH receptor stimulating antibodies were positive and immunohistochemical studies confirm the presence of TSH receptors on the struma ovarii. " 08/01/2006 - "The demonstration of TSH receptors on the struma ovarii increases previous speculation that struma ovarii growth and function may be augmented by the circulating TSH receptor stimulating antibodies of Graves' disease."
8.	Thyrotropin Receptors (Thyrotropin Receptor)IBA 08/01/2006 - "Circulating TSH receptor stimulating antibodies were positive and immunohistochemical studies confirm the presence of TSH receptors on the struma ovarii. " 08/01/2006 - "The demonstration of TSH receptors on the struma ovarii increases previous speculation that struma ovarii growth and function may be augmented by the circulating TSH receptor stimulating antibodies of Graves' disease." 08/01/2006 - "Graves' disease and coexisting struma ovarii: struma expression of thyrotropin receptors and the presence of thyrotropin receptor stimulating antibodies." 10/01/2013 - "The functionality of struma ovarii tissue in our patient was supported by the immunohistochemical identification of TSH receptors (TSHR), which may stimulate growth and thyroid hormone production in the presence of circulating TSHR stimulating antibodies (TSHR-Ab). "
9.	Radioisotopes (Radionuclides)IBA 02/01/1973 - "Radionuclide study of struma ovarii." 03/13/2020 - "Pelvic radioisotope scanning of a suspected Struma Ovarii causing thyrotoxicosis can be reserved for patients whose thyroid function remains abnormal after initial surgery. "
10.	AntigensIBA 12/01/2006 - "The aim of this study is to evaluate, through immunohistochemistry, the expression of TTF-1 in branchial cleft cysts with ectopic normal thyroid tissue, in primary thyroid papillary carcinomas of branchial cleft cysts and thyroglossal duct cysts and in struma ovarii, in order to evaluate the expression of this antigen in extra thyroidal sites." 05/01/2017 - "The monodermal teratoma struma ovarii is a rare ovarian tumour; however, struma ovarii presenting with pseudo-Meigs' syndrome and raised cancer antigen (CA)-125 levels is even rarer. "

Therapies and Procedures

1.	Thyroidectomy 12/01/2023 - "Over the course of 18 months, this lady underwent full pelvic clearance of malignant Struma Ovarii and lymph nodes, total thyroidectomy, and an anatomical lung resection. " 12/01/2018 - "Therefore, thyroidectomy followed by adjuvant I treatment should be recommended in patients with malignant struma ovarii as metastatic risk is difficult to predict based on histopathologic examination." 03/01/2009 - "In cases of metastatic struma ovarii, we recommend total thyroidectomy in conjunction with radioiodine scanning and radioiodine ablation. " 03/01/2009 - "Metastatic struma ovarii treated with total thyroidectomy and radioiodine ablation." 10/01/2008 - "Late struma ovarii diagnosis many years after total thyroidectomy. "
2.	Therapeutics 11/10/2022 - "Risk stratification of malignant struma ovarii is essential to determine suitable thyroid targeting adjuvant therapy and reduce the risk of recurrence." 08/11/2022 - "Management of malignant struma ovarii: is aggressive therapy justified? " 04/01/2022 - "High dose Radioiodine Therapy Preceded by Fertility Preservation Surgery in Metastatic Malignant Struma Ovarii: A Tale of Endurance and Prudent Management." 01/01/2021 - "Complete response of recurrent malignant struma ovarii followed by 131I therapy." 12/01/2016 - "This case is interesting as two rare entities, 131I therapy-related struma ovarii and drug-related breast uptake, were simultaneously visualized."
3.	Salpingo-oophorectomy 06/01/2014 - "Tumorectomy or salpingo-oophorectomy is the appropriate therapeutic treatment for benign struma ovarii. " 01/01/2019 - "A 67-year-old woman presented with malignant struma ovarii after radical bilateral salpingo-oophorectomy. " 06/01/2014 - "Four malignant struma ovarii, 1 patient underwent fertility-sparing staging surgery, 2 patients unilateral salpingo-oophorectomy, 1 case hysterectomy + bilateral salpingo-oophorectomy. " 07/01/2018 - "Before cryopreservation, the patient underwent two left ovarian surgeries for enucleation cysts 8 years after righ salpingo-oophorectomy for struma-ovarii. " 06/01/2014 - "Among patients with begin struma ovarii, 25 cases underwent cystectomy, 15 cases unilateral, 2 bilateral salpingo-oophorectomy, 22 cases hysterectomy + unilateral or bilateral salpingo-oophorectomy. "
4.	Neoadjuvant Therapy 11/01/2021 - "This study reports on a patient with preoperatively proven peritoneal metastasis of an 18 cm ovarian tumor with large struma ovarii and papillary thyroid carcinoma within the struma, who was treated with CRS and HIPEC after neoadjuvant chemotherapy. "
5.	Hyperthermic Intraperitoneal Chemotherapy 11/01/2021 - "Malignant Struma Ovarii Τreated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)." 11/01/2021 - "The objective of this case report is to present a patient with histopathologically confirmed malignant struma ovarii who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) with the aim of complete tumor resection. " 11/01/2021 - "This study reports on a patient with preoperatively proven peritoneal metastasis of an 18 cm ovarian tumor with large struma ovarii and papillary thyroid carcinoma within the struma, who was treated with CRS and HIPEC after neoadjuvant chemotherapy. "