Differentiating Struma ovarii from other diseases
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
Struma ovarii is a potentially malignant tumor, that should be differentiated from an ovarian mass with cystic, solid, or mixed cystic and solid structure. Struma ovarii must be differentiated from other diseases like benign and malignant ovarian neoplasm, ovarian cyst, endometrioma and tubo-ovarian abscess.
Differentiating Struma ovarii from other Diseases
- Struma ovarii is a potentially malignant tumor, that should be differentiated from an ovarian mass with cystic, solid, or mixed cystic and solid structure such as: [1][2][3][4][5][6][7] [8][9]
- Various benign and malignant ovarian neoplasms
- Endometrioma
- Ectopic Pregnancy
- Metastatic thyroid cancer to the ovary
- Ovarian cyst(Physiological)
- Tubo-ovarian abscess
- Hydrosalpinx
- Hyperthyroidism
Struma ovarii must be differentiated from other causes of hyperthyroidism such as Grave's disease and toxic nodular goiter:
| Cause of thyrotoxicosis | TSH receptor antibodies | Thyroid US | Color flow Doppler | Radioactive iodine uptake/Scan | Other features |
|---|---|---|---|---|---|
| Struma ovarii | - | Variable | Reduced/absent flow | ↓ | Abdominal RAIU |
| Toxic nodular goiter | - | Multiple nodules | - | Hot nodules at thyroid scan | - |
| Graves' disease | + | Hypoechoic pattern | ↑ | ↑ | Ophthalmopathy, dermopathy, acropachy |
| Toxic adenoma | - | Single nodule | - | Hot nodule | - |
| Subacute thyroiditis | - | Heterogeneous hypoechoic areas | Reduced/absent flow | ↓ | Neck pain, fever, and elevated inflammatory index |
| Painless thyroiditis | - | Hypoechoic pattern | Reduced/absent flow | ↓ | - |
| Amiodarone induced thyroiditis-Type 1 | - | Diffuse or nodular goiter | ↓/Normal/↑ | ↓ but higher than in Type 2 | High urinary iodine |
| Amiodarone induced thyroiditis-Type 2 | - | Normal | Absent | ↓/absent | High urinary iodine |
| Central hyperthyroidism | - | Diffuse or nodular goiter | Normal/↑ | ↑ | Inappropriately normal or high TSH |
| Trophoblastic disease | - | Diffuse or nodular goiter | Normal/↑ | ↑ | - |
| Factitious thyrotoxicosis | - | Variable | Reduced/absent flow | ↓ | ↓ Serum thyroglobulin |
References
- ↑ Kraemer B, Grischke EM, Staebler A, Hirides P, Rothmund R (2011). "Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment". Fertil Steril. 95 (6): 2124.e9–12. doi:10.1016/j.fertnstert.2010.12.047. PMID 21269611.
- ↑ Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS (2008). "Clinical characteristics of struma ovarii". J Gynecol Oncol. 19 (2): 135–8. doi:10.3802/jgo.2008.19.2.135. PMC 2676458.
- ↑ Park CH, Jung MH, Ji YI (2015). "Risk factors for malignant transformation of mature cystic teratoma". Obstet Gynecol Sci. 58 (6): 475–80. doi:10.5468/ogs.2015.58.6.475. PMC 4663225. PMID 26623411.
- ↑ Wee JY, Li X, Chern BS, Chua IS (2015). "Struma ovarii: management and follow-up of a rare ovarian tumour". Singapore Med J. 56 (1): 35–9. PMC 4325564. PMID 25640097.
- ↑ Dujardin MI, Sekhri P, Turnbull LW (2014). "Struma ovarii: role of imaging?". Insights Imaging. 5 (1): 41–51. doi:10.1007/s13244-013-0303-3. PMC 3948908. PMID 24357453.
- ↑ Mostaghel N, Enzevaei A, Zare K, Fallahian M (2012). "Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report". J Ovarian Res. 5: 10. doi:10.1186/1757-2215-5-10. PMC 3350392. PMID 22436494.
- ↑ Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K (2014). "Struma ovarii. A case report". Hippokratia. 18 (4): 357–8. PMC 4453812. PMID 26052205.
- ↑ Yücesoy G, Cakiroglu Y, Muezzinoglu B, Besnili B, Yucesoy I (2010). "Malignant struma ovarii: a case report". J. Korean Med. Sci. 25 (2): 327–9. doi:10.3346/jkms.2010.25.2.327. PMID 20119594.
- ↑ Rosenblum, NG; LiVolsi, VA; Edmonds, PR; Mikuta, JJ (1989). "Malignant struma ovarli". International Journal of Gynecology & Obstetrics. 30 (1): 80–81. doi:10.1016/0020-7292(89)90235-X. ISSN 0020-7292.