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Imaging of gynecological disease (4): clinical and ultrasound characteristics of struma ovarii

Savelli, L.; Testa, A. C.; Timmerman, D.; Paladini, D.; Ljungberg, Otto LU and Valentin, Lil LU (2008) In Ultrasound in Obstetrics & Gynecology 32(2). p.210-219
Abstract
Objectives To describe the clinical history and ultrasound findings in women with struma ovarii. Methods Women with a histological diagnosis of struma ovarii who bad undergone preoperative ultrasound examination were identified front the databases of five ultrasound centers. The tumors were characterized on the basis of ultrasound images,, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, four authors reviewed all ultrasound images and described them using pattern recognition. Results Of 31 patients identified, 16 bad pure struma ovarii (one malignant), whereas in 15 patients the struma ovarii were 'impure', constituting the... (More)
Objectives To describe the clinical history and ultrasound findings in women with struma ovarii. Methods Women with a histological diagnosis of struma ovarii who bad undergone preoperative ultrasound examination were identified front the databases of five ultrasound centers. The tumors were characterized on the basis of ultrasound images,, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, four authors reviewed all ultrasound images and described them using pattern recognition. Results Of 31 patients identified, 16 bad pure struma ovarii (one malignant), whereas in 15 patients the struma ovarii were 'impure', constituting the major part of a dermoid cyst (all benign, bilateral in one case). Median age was 40 (range, 18-80) years and 22 (71%) patients were of fertile age. Thirteen patients (42%) were asymptomatic, nine (29%) presented with pain, six (19%) with bloating, two (6%) with irregular bleeding and one (3%) with thyreotoxicosis. Most pure struma ovarii (11/16 cases, 69%) contained solid components, but cystic components were always present. The color content at Doppler examination varied front none to abundant. Four patients had ascites. Using pattern recognition the most specific feature of pure struma ovarii was the 'struma pearl', i.e. a smooth roundish solid area, similar, but not identical, to the 'round white ball' seen in dermoid cysts. 'Struma pearls' were present in six cases of Pure struma ovarii. Most (10116, 63%) cases of impure struma ovarii manifested ultrasound features compatible with a dermoid cyst, but six manifested ultrasound features similar to those of pure struma ovarii, 'struma pearls' being seen in three of these. Conclusions The sonographic features of struma ovarii vary. Struma ovarii may be suspected when a 'struma pearl' is seen. Whether 'struma pearls' are indeed a specific ultrasonographic feature of struma ovarii needs to be determined in a prospective study. Copyright (C) 2008 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
struma ovarii, ovary, dermoid cyst, Doppler, ultrasonography
in
Ultrasound in Obstetrics & Gynecology
volume
32
issue
2
pages
210 - 219
publisher
John Wiley & Sons
external identifiers
  • wos:000258972100015
  • scopus:51949093628
ISSN
1469-0705
DOI
10.1002/uog.5396
language
English
LU publication?
yes
id
df36c666-0421-4c2d-99f5-63dfe5ca8811 (old id 1246775)
date added to LUP
2008-11-19 11:08:20
date last changed
2017-10-01 04:20:26
@article{df36c666-0421-4c2d-99f5-63dfe5ca8811,
  abstract     = {Objectives To describe the clinical history and ultrasound findings in women with struma ovarii. Methods Women with a histological diagnosis of struma ovarii who bad undergone preoperative ultrasound examination were identified front the databases of five ultrasound centers. The tumors were characterized on the basis of ultrasound images,, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, four authors reviewed all ultrasound images and described them using pattern recognition. Results Of 31 patients identified, 16 bad pure struma ovarii (one malignant), whereas in 15 patients the struma ovarii were 'impure', constituting the major part of a dermoid cyst (all benign, bilateral in one case). Median age was 40 (range, 18-80) years and 22 (71%) patients were of fertile age. Thirteen patients (42%) were asymptomatic, nine (29%) presented with pain, six (19%) with bloating, two (6%) with irregular bleeding and one (3%) with thyreotoxicosis. Most pure struma ovarii (11/16 cases, 69%) contained solid components, but cystic components were always present. The color content at Doppler examination varied front none to abundant. Four patients had ascites. Using pattern recognition the most specific feature of pure struma ovarii was the 'struma pearl', i.e. a smooth roundish solid area, similar, but not identical, to the 'round white ball' seen in dermoid cysts. 'Struma pearls' were present in six cases of Pure struma ovarii. Most (10116, 63%) cases of impure struma ovarii manifested ultrasound features compatible with a dermoid cyst, but six manifested ultrasound features similar to those of pure struma ovarii, 'struma pearls' being seen in three of these. Conclusions The sonographic features of struma ovarii vary. Struma ovarii may be suspected when a 'struma pearl' is seen. Whether 'struma pearls' are indeed a specific ultrasonographic feature of struma ovarii needs to be determined in a prospective study. Copyright (C) 2008 ISUOG. Published by John Wiley & Sons, Ltd.},
  author       = {Savelli, L. and Testa, A. C. and Timmerman, D. and Paladini, D. and Ljungberg, Otto and Valentin, Lil},
  issn         = {1469-0705},
  keyword      = {struma ovarii,ovary,dermoid cyst,Doppler,ultrasonography},
  language     = {eng},
  number       = {2},
  pages        = {210--219},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Imaging of gynecological disease (4): clinical and ultrasound characteristics of struma ovarii},
  url          = {http://dx.doi.org/10.1002/uog.5396},
  volume       = {32},
  year         = {2008},
}