Struma Ovarii Treatment & Management

  • Author: Jeannie Chen Kelly, MD; Chief Editor: Michel E Rivlin, MD   more...
 
Updated: Nov 22, 2011
 

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%.[10]

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Contributor Information and Disclosures
Author

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

Disclosure: Nothing to disclose.

Coauthor(s)

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 and Society of Gynecologist Oncologists

Disclosure: Nothing to disclose.

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

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Jordan G Pritzker, MD, MBA, FACOG  Assistant Professor of Obstetrics/Gynecology and Women's Health, Women's Comprehensive Health Center, Hofstra University School of Medicine; Attending Physician, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

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.

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, 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.

Additional Contributors

The authors and editors of eMedicine 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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  9. 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. Sep 2004;94(3):835-9. [Medline].

  10. 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. Jun 2003;89(3):543-8. [Medline].

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