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Endocrine Pathology Online

Struma Ovarii with Papillary Carcinoma in Mature Cystic Ovarian Teratoma

Dr Sampurna Roy MD                                 




Struma ovarii is an extremely rare tumour that occasionally undergoes malignant transformation. 

Struma ovarii, a teratoma in which thyroid tissue is the predominant or sole component account for 2.7% of all ovarian tumours.

Because struma ovarii is composed of thyroid tissue, it is conceivable  that the pathogenetic events involved in thyroid follicular transformation may take place also in struma ovarii.

Pathogenesis is unclear.

In addition to symptoms and signs caused by the presence of a mass, struma may be associated with a number of unusual clinical manifestations.

Struma ovarii is rare ovarian tumour that is characterized by the presence of at least 50% thyroid tissue on histologic examination.

The presence of thyroid tissue in the ovary implies either metastatic thyroid carcinoma, or a monophyletic teratoma such as  "struma ovarii".

Always look out for other teratomatous elements,especially carcinoid tumour which is specifically associated with thyroid tissue in the ovary.

The thyroid tissue here can be affected by the full range of disease  processes which would otherwise affect the native thyroid gland.

Interpretation of malignant transformation in the tissue is difficult, but for papillary carcinoma, the criteria are the same as for the thyroid gland.

If the patient develops autoimmune thyroiditis, the "struma ovarii" shows similar changes in the native gland.


Further reading

Malignant struma ovarii--a case report and review of the literature.

Papillary carcinoma arising in struma ovarii versus ovarian metastasis from primary thyroid carcinoma: a case report and review of the literature.

Unusual characteristics and fatal outcome of a malignant struma ovarii. Case report and literature review.

Malignant struma ovarii: a case report and review of the literature.

Malignant struma ovarii: the west of Scotland experience and review of literature with focus on postoperative management.

Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report.

Monodermal teratomas (struma ovarii). Clinicopathological characteristics of 11 cases and literature review.

Struma ovarii and peritoneal strumosis with thyrotoxicosis.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

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