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Struma Ovarii Treatment & Management

  • Author: Lisa Rubinsak, MD; Chief Editor: Michel E Rivlin, MD  more...
 
Updated: Mar 02, 2016
 

Surgical Care

For the vast majority of cases, surgical resection of the ovary is sufficient to treat benign, unilateral disease. A paucity of evidence exists in the literature regarding conservative management in cases with evidence of malignancy. In these patients, serum thyroglobulin levels can be followed as a marker for recurrence following fertility-sparing unilateral salpingo-oophorectomy. In patients who do not desire future fertility, malignant struma ovarii necessitates surgical staging for ovarian cancer with pelvic washings, total abdominal hysterectomy, bilateral salpingo-oophorectomy, lymph node sampling, total thyroidectomy, and radioactive I-131 ablation. The recurrence rate in patients with malignant struma ovarii who undergo surgery without subsequent radioablation has been cited as high as 50%.[12]

 
 
Contributor Information and Disclosures
Author

Lisa Rubinsak, MD Fellow in Advanced Pelvic Surgery, Emory University School of Medicine

Lisa Rubinsak, MD is a member of the following medical societies: American Congress of Obstetricians and Gynecologists, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

David Chelmow, MD Leo J Dunn Professor and Chair, Department of Obstetrics and Gynecology, Virginia Commonwealth University Medical Center

David Chelmow, MD is a member of the following medical societies: Phi Beta Kappa, Sigma Xi, American College of Obstetricians and Gynecologists, American Society for Colposcopy and Cervical Pathology, Council of University Chairs of Obstetrics and Gynecology, Society for Academic Specialists in General Obstetrics and Gynecology, American Medical Association, Association of Professors of Gynecology and Obstetrics, Society for Reproductive Investigation, Society for Medical Decision Making

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

A David Barnes, MD, MPH, PhD, FACOG Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, CA), Pioneer Valley Hospital (Salt Lake City, UT), Warren General Hospital (Warren, PA), and Mountain West Hospital (Tooele, UT)

A David Barnes, MD, MPH, PhD, FACOG is a member of the following medical societies: American College of Forensic Examiners Institute, American College of Obstetricians and Gynecologists, Association of Military Surgeons of the US, American Medical Association, Utah Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD Former Professor, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine

Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, Royal College of Surgeons of Edinburgh, Royal College of Obstetricians and Gynaecologists

Disclosure: Nothing to disclose.

Additional Contributors

Jordan G Pritzker, MD, MBA, FACOG Adjunct Professor of Obstetrics/Gynecology, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Attending Physician, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center; Medical Director, Aetna, Inc; Private Practice in Gynecology

Disclosure: Nothing to disclose.

Jeannie Chen Kelly, MD Resident Physician, Department of Obstetrics and Gynecology, Tufts Medical Center

Disclosure: Nothing to disclose.

Sarah H Hughes, MD Assistant Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Massachusetts Medical School

Sarah H Hughes, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Society of Gynecologic Oncology

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Bradford W Fenton, MD, PhD, FACOG to the development and writing of this article.

References
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  12. DeSimone CP, Lele SM, Modesitt SC. Malignant struma ovarii: a case report and analysis of cases reported in the literature with focus on survival and I131 therapy. Gynecol Oncol. 2003 Jun. 89(3):543-8. [Medline].

  13. Makani S, Kim W, Gaba AR. Struma Ovarii with a focus of papillary thyroid cancer: a case report and review of the literature. Gynecol Oncol. 2004 Sep. 94(3):835-9. [Medline].

  14. Robboy SJ, Shaco-Levy R, Peng RY, Snyder MJ, Donahue J, Bentley RC. Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread. Int J Gynecol Pathol. 2009 Sep. 28(5):405-22. [Medline].

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