Differentiating Struma ovarii from other diseases: Difference between revisions

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__NOTOC__
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{{Struma ovarii}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Struma_ovarii]]
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{ARK}}


==Overview==
==Overview==
Struma ovarii which is potentially malignant 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.
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==
==Differentiating Struma ovarii from other Diseases==


*Struma ovarii which is potentially malignant should be differentiated from an ovarian mass with cystic, solid, or mixed cystic and solid structure. <ref name="pmid21269611">{{cite journal| author=Kraemer B, Grischke EM, Staebler A, Hirides P, Rothmund R| title=Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment. | journal=Fertil Steril | year= 2011 | volume= 95 | issue= 6 | pages= 2124.e9-12 | pmid=21269611 | doi=10.1016/j.fertnstert.2010.12.047 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21269611  }} </ref>
*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: <ref name="pmid21269611">{{cite journal| author=Kraemer B, Grischke EM, Staebler A, Hirides P, Rothmund R| title=Laparoscopic excision of malignant struma ovarii and 1 year follow-up without further treatment. | journal=Fertil Steril | year= 2011 | volume= 95 | issue= 6 | pages= 2124.e9-12 | pmid=21269611 | doi=10.1016/j.fertnstert.2010.12.047 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21269611  }} </ref><ref name="pmid">{{cite journal |vauthors=Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS |title=Clinical characteristics of struma ovarii |journal=J Gynecol Oncol |volume=19 |issue=2 |pages=135–8 |year=2008 |pmid= |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |url=}}</ref><ref name="pmid26623411">{{cite journal |vauthors=Park CH, Jung MH, Ji YI |title=Risk factors for malignant transformation of mature cystic teratoma |journal=Obstet Gynecol Sci |volume=58 |issue=6 |pages=475–80 |year=2015 |pmid=26623411 |pmc=4663225 |doi=10.5468/ogs.2015.58.6.475 |url=}}</ref><ref name="pmid25640097">{{cite journal |vauthors=Wee JY, Li X, Chern BS, Chua IS |title=Struma ovarii: management and follow-up of a rare ovarian tumour |journal=Singapore Med J |volume=56 |issue=1 |pages=35–9 |year=2015 |pmid=25640097 |pmc=4325564 |doi= |url=}}</ref><ref name="pmid24357453">{{cite journal |vauthors=Dujardin MI, Sekhri P, Turnbull LW |title=Struma ovarii: role of imaging? |journal=Insights Imaging |volume=5 |issue=1 |pages=41–51 |year=2014 |pmid=24357453 |pmc=3948908 |doi=10.1007/s13244-013-0303-3 |url=}}</ref><ref name="pmid22436494">{{cite journal |vauthors=Mostaghel N, Enzevaei A, Zare K, Fallahian M |title=Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report |journal=J Ovarian Res |volume=5 |issue= |pages=10 |year=2012 |pmid=22436494 |pmc=3350392 |doi=10.1186/1757-2215-5-10 |url=}}</ref><ref name="pmid26052205">{{cite journal |vauthors=Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K |title=Struma ovarii. A case report |journal=Hippokratia |volume=18 |issue=4 |pages=357–8 |year=2014 |pmid=26052205 |pmc=4453812 |doi= |url=}}</ref> <ref name="pmid20119594">{{cite journal |vauthors=Yücesoy G, Cakiroglu Y, Muezzinoglu B, Besnili B, Yucesoy I |title=Malignant struma ovarii: a case report |journal=J. Korean Med. Sci. |volume=25 |issue=2 |pages=327–9 |year=2010 |pmid=20119594 |doi=10.3346/jkms.2010.25.2.327 |url=}}</ref><ref name="RosenblumLiVolsi1989">{{cite journal|last1=Rosenblum|first1=NG|last2=LiVolsi|first2=VA|last3=Edmonds|first3=PR|last4=Mikuta|first4=JJ|title=Malignant struma ovarli|journal=International Journal of Gynecology & Obstetrics|volume=30|issue=1|year=1989|pages=80–81|issn=00207292|doi=10.1016/0020-7292(89)90235-X}}</ref>


*Struma ovarii must be differentiated from other diseases that cause: <ref name="pmid">{{cite journal |vauthors=Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS |title=Clinical characteristics of struma ovarii |journal=J Gynecol Oncol |volume=19 |issue=2 |pages=135–8 |year=2008 |pmid= |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |url=}}</ref> <ref name="pmid26623411">{{cite journal |vauthors=Park CH, Jung MH, Ji YI |title=Risk factors for malignant transformation of mature cystic teratoma |journal=Obstet Gynecol Sci |volume=58 |issue=6 |pages=475–80 |year=2015 |pmid=26623411 |pmc=4663225 |doi=10.5468/ogs.2015.58.6.475 |url=}}</ref> <ref name="pmid25640097">{{cite journal |vauthors=Wee JY, Li X, Chern BS, Chua IS |title=Struma ovarii: management and follow-up of a rare ovarian tumour |journal=Singapore Med J |volume=56 |issue=1 |pages=35–9 |year=2015 |pmid=25640097 |pmc=4325564 |doi= |url=}}</ref> <ref name="pmid24357453">{{cite journal |vauthors=Dujardin MI, Sekhri P, Turnbull LW |title=Struma ovarii: role of imaging? |journal=Insights Imaging |volume=5 |issue=1 |pages=41–51 |year=2014 |pmid=24357453 |pmc=3948908 |doi=10.1007/s13244-013-0303-3 |url=}}</ref> <ref name="pmid22436494">{{cite journal |vauthors=Mostaghel N, Enzevaei A, Zare K, Fallahian M |title=Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report |journal=J Ovarian Res |volume=5 |issue= |pages=10 |year=2012 |pmid=22436494 |pmc=3350392 |doi=10.1186/1757-2215-5-10 |url=}}</ref> <ref name="pmid26052205">{{cite journal |vauthors=Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K |title=Struma ovarii. A case report |journal=Hippokratia |volume=18 |issue=4 |pages=357–8 |year=2014 |pmid=26052205 |pmc=4453812 |doi= |url=}}</ref> <ref name="pmid20119594">{{cite journal |vauthors=Yücesoy G, Cakiroglu Y, Muezzinoglu B, Besnili B, Yucesoy I |title=Malignant struma ovarii: a case report |journal=J. Korean Med. Sci. |volume=25 |issue=2 |pages=327–9 |year=2010 |pmid=20119594 |doi=10.3346/jkms.2010.25.2.327 |url=}}</ref> <ref name="RosenblumLiVolsi1989">{{cite journal|last1=Rosenblum|first1=NG|last2=LiVolsi|first2=VA|last3=Edmonds|first3=PR|last4=Mikuta|first4=JJ|title=Malignant struma ovarli|journal=International Journal of Gynecology & Obstetrics|volume=30|issue=1|year=1989|pages=80–81|issn=00207292|doi=10.1016/0020-7292(89)90235-X}}</ref>
:*Various [[benign]] and [[malignant]] ovarian neoplasms
:*[[Endometrioma]]
:*[[Ectopic pregnancy|Ectopic Pregnancy]]
:*[[Metastatic]] [[thyroid cancer]] to the ovary       
:*[[Ovarian cyst]](Physiological)
:*[[Tubo-ovarian abscess]]
:*[[Hydrosalpinx]]         
:*[[Hyperthyroidism]]


:*Various benign and malignant ovarian neoplasms
==== Struma ovarii must be differentiated from other causes of [[hyperthyroidism]] such as [[Graves' disease|Grave's disease]] and [[Toxic multinodular goiter|toxic nodular goiter]]: ====
:*Endometrioma
 
:*Ectopic Pregnancy
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
:*Metastatic thyroid cancer to the ovary       
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Cause of thyrotoxicosis}}
:*Ovarian cyst(Physiological)
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|TSH receptor antibodies}}
:*Tubo-ovarian abscess
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Thyroid US}}
:*Hydrosalpinx         
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Color flow Doppler}}
:*Hyperthyroidism
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Radioactive iodine uptake/Scan}}
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Other features}}
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Struma ovarii}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Variable
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
| style="padding: 5px 5px; background: #F5F5F5;" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" | Abdominal RAIU
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic nodular goiter}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Multiple nodules
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodules at thyroid scan
| style="padding: 5px 5px; background: #F5F5F5;" | -
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Graves' disease}}
| style="padding: 5px 5px; background: #F5F5F5;" | +
| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern
| style="padding: 5px 5px; background: #F5F5F5;" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" | Ophthalmopathy, dermopathy, acropachy
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic adenoma}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Single nodule
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodule
| style="padding: 5px 5px; background: #F5F5F5;" | -
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Subacute thyroiditis}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Heterogeneous hypoechoic areas
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
| style="padding: 5px 5px; background: #F5F5F5;" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" | Neck pain, fever, and<br> elevated inflammatory index
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Painless thyroiditis}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
| style="padding: 5px 5px; background: #F5F5F5;" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" | -
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 1}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
| style="padding: 5px 5px; background: #F5F5F5;" | ↓/Normal/↑
| style="padding: 5px 5px; background: #F5F5F5;" | ↓ but higher than in Type 2
| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 2}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Normal
| style="padding: 5px 5px; background: #F5F5F5;" | Absent
| style="padding: 5px 5px; background: #F5F5F5;" | ↓/absent
| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Central hyperthyroidism}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
| style="padding: 5px 5px; background: #F5F5F5;" | Normal/↑
| style="padding: 5px 5px; background: #F5F5F5;" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" | Inappropriately normal or high TSH
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Trophoblastic disease}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
| style="padding: 5px 5px; background: #F5F5F5;" | Normal/↑
| style="padding: 5px 5px; background: #F5F5F5;" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" | -
|-
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Factitious thyrotoxicosis}}
| style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;" | Variable
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
| style="padding: 5px 5px; background: #F5F5F5;" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" | ↓ Serum thyroglobulin
|-
|}


==References==
==References==

Latest revision as of 19:09, 25 February 2019

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 neoplasmovarian cystendometrioma and tubo-ovarian abscess.

Differentiating Struma ovarii from other Diseases

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K (2014). "Struma ovarii. A case report". Hippokratia. 18 (4): 357–8. PMC 4453812. PMID 26052205.
  8. 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.
  9. 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.

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