MALIGNANT STRUMA OVARII: CLINIC AND PATHOLOGICAL FEATURES

Abstract
Struma ovarii is an ovarian teratoma formed predominantly by thyroid tissue. Most struma ovarii are not clinically suspected and the diagnosis is made by histopathological analysis performed after the excision of the mass, which normally is discovered in routine examinations. In rare instances undergo malignant change as papillary carcinomas, follicular carcinomas or a mixture of both. Although the criteria of malignancy are still subject of controversy, most authors agree they must be based in the histological criteria of malignancy of thyroid tumors, including ground-glass nuclei appearance, associated to nuclear grooves and pseudoinclusions.The presence of metastases is an useful but not obligatory criterion for the diagnosis of malignancy since they are present in only 5% to 6% of malignant struma ovarii. In the majority of patients the tumor is staged Ia (FIGO). Even with metastases, however, the prognosis is excellent. The treatment consists in surgical excision of assaulted appendage, followed or not by radical pan-hysterectomy and ablation with radioactive iodine.

Key words
Struma ovarii, malignant, diagnosis, prognosis, treatment

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