Ovarian goiter or struma ovarii: Case study and literature review

Struma ovarii tumor is a subtype of an ovarian teratoma and is composed entirely or predominantly of thyroid tissue and containing variable-sized follicles with colloid material. To qualify as a struma ovarii tumors more than 50% of the tumor should be composed of thyroid tissue. (1) Approximately 5-8% of cases can show symptoms or signs of thyrotoxicosis. (2)
We report the case of a single 42-year-old woman admitted with pelvic pain associated with a mass. Radiologic examination revealed an adnexal tumor with great abundance ascites and no signs of metastasis. The patient underwent surgical treatment, which confirmed the presence of thyroid tissue in the left ovary, suggestive of Struma ovari tumor. The clinical and radiologic data are nonspecific. Histological examination is required for the diagnosis and is based on a biopsy or surgical specimen. (3) 
During the review period, a number of papers were published reporting series of patients with malignant ovarian germ cell tumors and describing the increasingly successful worldwide trend observed in treatment of such patients. Publications dealing solely with the successful management of patients with pure dysgerminoma, using surgery followed by chemotherapy which is less likely to affect fertility compared with radiation therapy. (4)
The aim of this case is to highlight this exceptional histological type, which first requires an appropriate diagnostic strategy to rule out metastatic involvement from a primary thyroid tumor before confirming the diagnosis of struma ovarii.