Struma Ovari: 3. Basamak bir merkezin 3 yıllık deneyimi

Abstract

Struma Ovarii: 3 years’ experience of a tertiary center Objective: Struma ovarii accounts 0.5-1% of all ovarian tumors and 2-5% of ovarian teratomas. Struma ovarii cases are usually benign, only 5-10% of cases are malignant and the most common type of malignancy is papillary thyroid carcinoma(70%). The struma ovarii may be seen in all ages but it is generally seen in 5th and 6th decade of life. Although most of the cases are benign, clinical and radiological similarities to malignant masses leads to treatment with laparotomy. In the present study 3 years’ experience of a tertiary center's struma ovarii cases were studied.Material-Methods: Patients who underwent surgery for adnexal masses were investigated from achieves of the hospital. Among pathology results 6 patients with struma ovarii were detected. Results: When the ages of the patients are evaluated, the youngest patient was 29 years old and the oldest patient was 71 years old age. Two of the patients were in the fourth decade and remaining two were in the fifth decade Maximum size of the adnexal mass 18 cm and the minumum size was 6 cm in lenght.Among 6 cases of struma ovarii 3 of them had a frozen section diagnosis of struma ovarii. In final histopathological diagnosis 3 of the cases had accompanying malignancies. One of the malignant case was a metastasis of breast carcinoma to struma ovarii.Conclusion: Struma ovarii is a monodermal teratoma where there is extensive differentiation to thyroid tissue. Among ovarian tumors, it accounts 0.5-1%. A total number of 185 patients underwent surgery in our center for ovarian masses in the last 3 years. Six struma ovarii cases were detected among those cases which approximately accounts 3.2% of all ovarian mass cases. This increased ratio may be attributable to the status of our center in which complicated cases are referred. Struma ovarii cases are generally benign in nature. Only 5-10 % of malignant cases are detected in struma ovaries. The mostly seen malignancy in struma ovarii is the papillary thyroid carcinoma. Among our 6 cases, one patient (16%) had a malignancy of papillary carcinoma. Similarly, Wei et al. showed 10 papillary carcinomas among 96 cases of struma ovarii. Although struma ovarii has a benign course macroscopic and microscopic examinations are important to detect rare malignancies. In most of the cases, the course of strumosis is uneventful. In our cases, patients are followed up without disease. Struma ovarii may show changes similar to thyroid pathologies. Hashimoto like thyroiditis may be seen. Patients may have simultaneous thyroid pathology. In our series preoperative and postoperative TSH levels and thyroid ultrasound of all patients were in normal range. As a conclusion Struma ovarii cases are generally benign in nature but malignancy risk and accompanying thyroid diseases should be kept in mind during follow up of struma ovarii cases.