eMedicine Specialties > Obstetrics and Gynecology > General Gynecology

Struma Ovarii: Treatment & Medication

Author: Bradford W Fenton, MD, PhD, FACOG, Clinical Assistant Professor, Northeast Ohio Universities College of Medicine; Faculty, Obstetrics and Gynecology Residency Training Program, Summa Hospitals Department of Obstetrics and Gynecology; Medical Director, Pelvic Pain Specialty Center
Contributor Information and Disclosures

Updated: Oct 26, 2009

Treatment

Medical Care

  • Ablation with iodine-131 has been advocated as adjunctive therapy if pathological examination or staging suggests malignant transformation.
  • Repeat treatment is still therapeutic if recurrence is detected.

Surgical Care

Definitive therapy depends on the extent of preoperative disease and the future childbearing wishes of the patient.

  • Since most cases are unilateral and benign, simple oophorectomy is appropriate for most patients.
  • If the contralateral ovary is involved or if the patient has finished childbearing, total hysterectomy with bilateral salpingo-oophorectomy is appropriate.
  • If evidence of peritoneal metastasis is present, appropriate debulking is indicated. In patients with thyroid involvement, a concomitant thyroidectomy has been advocated.
  • Preoperative details
    • Symptoms of thyroid involvement are rare, thus preoperative thyroid testing or thyroid scanning is unlikely to have occurred.
    • Most cases are found incidentally.
  • Intraoperative details
    • Most cases are found as part of a mature teratoma.
    • Standard surgical resection is sufficient.
  • Postoperative details
    • Postoperative changes in thyroid function can range from hypothyroidism to thyroid storm.
    • Stimulating antibody release has been implicated in hyperthyroid cases.

More on Struma Ovarii

Overview: Struma Ovarii
Differential Diagnoses & Workup: Struma Ovarii
Treatment & Medication: Struma Ovarii
Follow-up: Struma Ovarii
References
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References

  1. Utsunomiya D, Shiraishi S, Kawanaka K. Struma ovarii coexisting with mucinous cystadenoma detected by radioactive iodine. Clin Nucl Med. 2003;28(9):725-7. [Medline]. [Full Text].

  2. McGill JF, Sturgeon C, Angelos P. Metastatic struma ovarii treated with total thyroidectomy and radioiodine ablation. Endocr Pract. Mar 2009;15(2):167-73. [Medline].

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

  4. Dardik RB, Dardik M, Westra W. Malignant struma ovarii: two case reports and a review of the literature. Gynecol Oncol. Jun 1999;73(3):447-51. [Medline].

  5. Ihalagama IR, Hewavisenthi SJ, Wijesinghe PS. Pregnancy following treated malignant struma ovarii. Ceylon Med J. Sep 2004;49(3):90-1. [Medline].

  6. Roth LM, Talerman A. The enigma of struma ovarii. Pathology. Feb 2007;39(1):139-46. [Medline].

  7. Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS. Clinical characteristics of struma ovarii. J Gynecol Oncol. Jun 2008;19(2):135-8. [Medline].

  8. Zakhem A, Aftimos G, Kreidy R. Malignant struma ovarii: report of two cases and selected review of the literature. J Surg Oncol. Jan 1990;43(1):61-5. [Medline].

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Further Reading

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Keywords

teratomatous ovarian tumor, hyperthyroidism, cystadenomas, strumosis, teratoma, pelvic mass, oophorectomy, total hysterectomy, bilateral salpingo-oophorectomy, thyroidectomy

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Contributor Information and Disclosures

Author

Bradford W Fenton, MD, PhD, FACOG, Clinical Assistant Professor, Northeast Ohio Universities College of Medicine; Faculty, Obstetrics and Gynecology Residency Training Program, Summa Hospitals Department of Obstetrics and Gynecology; Medical Director, Pelvic Pain Specialty Center
Bradford W Fenton, MD, PhD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists
Disclosure: Nothing to disclose.

Medical Editor

Jordan G Pritzker, MD, MBA, FACOG, Assistant Professor of Obstetrics, Gynecology, and Women's Health, Women's Comprehensive Health Center, Albert Einstein College of Medicine; Physician-In-Charge, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

A David Barnes, MD, PhD, MPH, FACOG, Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, California), Pioneer Valley Hospital (Salt Lake City, Utah), Warren General Hospital (Warren, Pennsylvania), and Mountain West Hospital (Tooele, Utah)
A David Barnes, MD, PhD, MPH, FACOG is a member of the following medical societies: American College of Forensic Examiners, American College of Obstetricians and Gynecologists, American Medical Association, Association of Military Surgeons of the US, and Utah Medical Association
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD, Professor, Coordinator of Quality Assurance/Quality Improvement, 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, and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

 
 
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