Struma ovarii physical examination: Difference between revisions

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{{Struma ovarii}}
{{Struma ovarii}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{ARK}}
==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with struma ovarii usually appear normal. Physical examination of patients with Struma ovarii is usually remarkable for palpable lower [[abdominal mass]]. Pelvic pressure related to a [[Pelvic masses|pelvic mass]] is observed. Struma ovarii appears to occur more frequently in the right [[adnexa]]. In some cases [[ascites]] may be observed.
OR


Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
==Physical Examination==
==Physical Examination==
*Physical examination of patients with Struma ovarii is usually remarkable for:
*Physical examination of patients with Struma ovarii is usually remarkable for:
:*Palpable lower abdominal mass
:*Palpable lower [[abdominal mass]]
:*Pelvic pressure related to a pelvic mass
:*Pelvic pressure related to a [[Pelvic masses|pelvic mass]]
*Struma ovarii appears to occur more frequently (68.8%) in the right adnexa and CA-125 level appears within normal limits. <ref name="pmid11127011">{{cite journal |vauthors=Zalel Y, Seidman DS, Oren M, Achiron R, Gotlieb W, Mashiach S, Goldenberg M |title=Sonographic and clinical characteristics of struma ovarii |journal=J Ultrasound Med |volume=19 |issue=12 |pages=857–61 |year=2000 |pmid=11127011 |doi= |url=}}</ref>
*Struma ovarii appears to occur more frequently (68.8%) in the right [[adnexa]] and [[CA-125]] level appears within normal limits. <ref name="pmid11127011">{{cite journal |vauthors=Zalel Y, Seidman DS, Oren M, Achiron R, Gotlieb W, Mashiach S, Goldenberg M |title=Sonographic and clinical characteristics of struma ovarii |journal=J Ultrasound Med |volume=19 |issue=12 |pages=857–61 |year=2000 |pmid=11127011 |doi= |url=}}</ref>
*Clinical features in struma ovarii are generally non-specific and resemble ovarian malignancy. <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>
*Clinical features in struma ovarii are generally non-specific and resemble ovarian [[malignancy]]. <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>
*Pre-operative radiological diagnosis is essential inorder to avoid ovarian cancer type surgery (bilateral salpingo-oophorectomy, hysterectomy, omentectomy and occasionally appendectomy). <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>
*Advanced MRI may be helpful in identifying and to determine the unusual ovarian mass. <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>
*Occasionally Struma ovarii may present as a purely cystic lesion. <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>
 
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with Struma ovarii usually appear asymptomatic and some may experience discomfort in the abdomen due to pelvic pressure related to a pelvic mass.
*Patients with struma ovarii usually appear asymptomatic and some may experience discomfort in the abdomen due to pelvic pressure related to a [[Pelvic masses|pelvic mass]].
*[[Facial flushing]] is seen very rarely. <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="pmid11259710">{{cite journal |vauthors=Outwater EK, Siegelman ES, Hunt JL |title=Ovarian teratomas: tumor types and imaging characteristics |journal=Radiographics |volume=21 |issue=2 |pages=475–90 |year=2001 |pmid=11259710 |doi=10.1148/radiographics.21.2.g01mr09475 |url=}}</ref>


===Vital Signs===
===Vital Signs===
*Vital signs in a patient with Struma ovarii appear to be normal.
*Vital signs in a patient with struma ovarii appear to be normal.
 
===Skin===
*There haven't been any skin manifestations reported associated with Struma ovarii.
 
===HEENT===
*There are no significant findings associated with Struma ovarii.
 
===Neck===
*There are no significant findings associated with Struma ovarii.


===Lungs===
===Lungs===
*In malignant struma ovarii, distant metastases to the lungs have been observed. <ref name="pmid22613573">{{cite journal |vauthors=Selvaggi F, Risio D, Waku M, Simo D, Angelucci D, D'Aulerio A, Cotellese R, Innocenti P |title=Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report |journal=World J Surg Oncol |volume=10 |issue= |pages=93 |year=2012 |pmid=22613573 |pmc=3586957 |doi=10.1186/1477-7819-10-93 |url=}}</ref>
*In malignant struma ovarii, distant [[metastases]] to the [[lungs]] have been observed. <ref name="pmid22613573">{{cite journal |vauthors=Selvaggi F, Risio D, Waku M, Simo D, Angelucci D, D'Aulerio A, Cotellese R, Innocenti P |title=Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report |journal=World J Surg Oncol |volume=10 |issue= |pages=93 |year=2012 |pmid=22613573 |pmc=3586957 |doi=10.1186/1477-7819-10-93 |url=}}</ref>
*In some cases of Struma ovarii, hydrothorax has been observed. <ref name="pmid19471561">{{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=19471561 |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |url=}}</ref>
*In some cases of Struma ovarii, [[hydrothorax]] has been observed. <ref name="pmid19471561">{{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=19471561 |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |url=}}</ref>


===Heart===
===Heart===
*Tachycardia <ref name="pmid19471561">{{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=19471561 |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |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>
*[[Tachycardia]] <ref name="pmid19471561">{{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=19471561 |pmc=2676458 |doi=10.3802/jgo.2008.19.2.135 |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>


===Abdomen===
===Abdomen===
*Palpable lower abdominal mass
*Palpable lower [[abdominal mass]]
 
*May present with [[ascites]] in some cases. <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="pmid12611097">{{cite journal |vauthors=Bokhari A, Rosenfeld GS, Cracchiolo B, Heller DS |title=Cystic struma ovarii presenting with ascites and an elevated CA-125 level. A case report |journal=J Reprod Med |volume=48 |issue=1 |pages=52–6 |year=2003 |pmid=12611097 |doi= |url=}}</ref><ref name="pmid16343201">{{cite journal |vauthors=Rim SY, Kim SM, Choi HS |title=Struma ovarii showing clinical characteristics of ovarian malignancy |journal=Int. J. Gynecol. Cancer |volume=15 |issue=6 |pages=1156–9 |year=2005 |pmid=16343201 |doi=10.1111/j.1525-1438.2005.00328.x |url=}}</ref>
===Back===
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
*A pelvic mass may be palpated
*A [[Pelvic masses|pelvic mass]] may be palpated.
*Pelvic pressure related to a pelvic mass
*Pelvic pressure related to a [[Pelvic masses|pelvic mass]].
 
===Neuromuscular===
*No significant neuromuscular findings observed.
 
===Extremities===
*No significant findings observed


==References==
==References==

Latest revision as of 14:14, 16 October 2017

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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

Patients with struma ovarii usually appear normal. Physical examination of patients with Struma ovarii is usually remarkable for palpable lower abdominal mass. Pelvic pressure related to a pelvic mass is observed. Struma ovarii appears to occur more frequently in the right adnexa. In some cases ascites may be observed.

Physical Examination

  • Physical examination of patients with Struma ovarii is usually remarkable for:
  • Struma ovarii appears to occur more frequently (68.8%) in the right adnexa and CA-125 level appears within normal limits. [1]
  • Clinical features in struma ovarii are generally non-specific and resemble ovarian malignancy. [2]

Appearance of the Patient

  • Patients with struma ovarii usually appear asymptomatic and some may experience discomfort in the abdomen due to pelvic pressure related to a pelvic mass.
  • Facial flushing is seen very rarely. [2][3]

Vital Signs

  • Vital signs in a patient with struma ovarii appear to be normal.

Lungs

Heart

Abdomen

Genitourinary

References

  1. Zalel Y, Seidman DS, Oren M, Achiron R, Gotlieb W, Mashiach S, Goldenberg M (2000). "Sonographic and clinical characteristics of struma ovarii". J Ultrasound Med. 19 (12): 857–61. PMID 11127011.
  2. 2.0 2.1 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.
  3. Outwater EK, Siegelman ES, Hunt JL (2001). "Ovarian teratomas: tumor types and imaging characteristics". Radiographics. 21 (2): 475–90. doi:10.1148/radiographics.21.2.g01mr09475. PMID 11259710.
  4. Selvaggi F, Risio D, Waku M, Simo D, Angelucci D, D'Aulerio A, Cotellese R, Innocenti P (2012). "Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report". World J Surg Oncol. 10: 93. doi:10.1186/1477-7819-10-93. PMC 3586957. PMID 22613573.
  5. 5.0 5.1 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. PMID 19471561.
  6. 6.0 6.1 Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K (2014). "Struma ovarii. A case report". Hippokratia. 18 (4): 357–8. PMC 4453812. PMID 26052205.
  7. Bokhari A, Rosenfeld GS, Cracchiolo B, Heller DS (2003). "Cystic struma ovarii presenting with ascites and an elevated CA-125 level. A case report". J Reprod Med. 48 (1): 52–6. PMID 12611097.
  8. Rim SY, Kim SM, Choi HS (2005). "Struma ovarii showing clinical characteristics of ovarian malignancy". Int. J. Gynecol. Cancer. 15 (6): 1156–9. doi:10.1111/j.1525-1438.2005.00328.x. PMID 16343201.

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