Struma Ovarii: Single Center Experience

Objective: Struma ovarii (SO) accounts for approximately 1% of all ovarian tumors The objective of our study is to contribute to the treatment algorithm by presenting our clinical experience in a comprehensive case series of patients diagnosed with SO, predominantly characterized by thyroid tissue within a monodermal teratoma.
Materials and Methods: Patients aged 17 years and older who underwent surgery due to ovarian masses and were histopathologically diagnosed with SO between January 2012 and January 2022 were included in the study. The patients' files were retrospectively reviewed. Demographic data, presenting complaints, radiological findings, tumor sizes, laboratory data, surgical procedures performed, pathology reports, additional treatments, and follow-up information were recorded.
Results: The median age of total 19 patients was 41.7 (17-74) years. Among them, malignant struma ovarii was present in 3 patients. In patients with histopathologically confirmed benign struma ovarii, no additional treatment was administered after tumor enucleation. In malignant cases, in addition to unilateral salpingo-oophorectomy, total thyroidectomy, radioactive iodine (RAI) ablation, and L-Thyroxine suppression were performed. No mortality occurred during the follow-up period.
Conclusion: Although conservative treatments are considered as acceptable treatment in cases of benign struma ovarii, the management of cases with malignant struma ovarii is controversial. Fertility sparing surgery followed by postoperative adjuvant thyroidectomy and radioactive iodine ablation may be preferred for young women.

Struma Ovarii: Tek Merkez Deneyim

Amaç: Struma ovarii (SO) tüm yumurtalýk tümörlerinin yaklaþýk %1'ini oluþturur. Çalýþmamýzýn amacý, aðýrlýklý olarak monodermal teratom içinde tiroid dokusu ile karakterize SO tanýsý alan hastalardan oluþan kapsamlý bir vaka serisindeki klinik deneyimimizi sunarak tedavi algoritmasýna katkýda bulunmaktýr.
Yöntem: Ocak 2012 ile Ocak 2022 tarihleri arasýnda yumurtalýk kitlesi nedeniyle ameliyat edilen ve histopatolojik olarak SO tanýsý alan 17 yaþ ve üzeri hastalar çalýþmaya dahil edildi. Hastalarýn dosyalarý geriye dönük olarak incelendi. Demografik veriler, baþvuru þikayetleri, radyolojik bulgular, tümör boyutlarý, laboratuvar verileri, uygulanan cerrahi iþlemler, patoloji raporlarý, ek tedaviler ve takip bilgileri kaydedildi.
Bulgular: Toplam 19 hastanýn yaþ ortalamasý 41,7 ± 17,59 yýldý. Bunlardan 3 hastada malign struma ovarii (MSO) mevcuttu. Histopatolojik olarak benign struma ovarii (BSO) tanýsý doðrulanan hastalara kistektomi sonrasý ek tedavi uygulanmadý. Malign vakalarda tek taraflý salpingo-ooferektominin yaný sýra total tiroidektomi, radyoaktif iyot (RAI) ablasyonu ve L-Tiroksin baskýlamasý (TSH serum düzeyinin 0,1 mU/L'nin altýnda olmasý) uygulandý. Takip süresi boyunca mortalite meydana gelmedi.
Sonuç: Benign struma ovarii vakalarýnda konservatif tedaviler kabul edilebilir bir tedavi olarak görülse de malign vakalarýnýn yönetimi tartýþmalýdýr. Genç kadýnlar için doðurganlýðý koruyucu cerrahiyi takiben postoperatif adjuvan tiroidektomi ve radyoaktif iyot ablasyonu tercih edilebilir. (SETB-2024-05-079)