Struma ovarii: management and follow-up of a rare ovarian tumour

• Published in: Singapore medical journal 2015-01, Vol.56 (1), p.35-39
• Main Authors: Wee, Jonathan Yeow Sherng, Li, Xinyi, Chern, Bernard Su Min, Chua, Irene Sze Yuen
• Format: Article
• Language: English
• Subjects: Cystectomy; Female; Follow-Up Studies; Humans; Hysterectomy; Laparoscopy; Length of Stay; Middle Aged; Neoplasm Recurrence, Local - surgery; Original; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - surgery; Ovariectomy; Ovary - pathology; Postoperative Period; Retrospective Studies; Salpingectomy; Singapore; Struma Ovarii - diagnosis; Struma Ovarii - surgery
• ISSN: 0037-5675
• DOI: 10.11622/smedj.2015007

Struma ovarii represents about 1.0% of all ovarian tumours. While management involves surgery, there is a paucity of data regarding the extent and approach of surgery, and postoperative management. This study aimed to delineate the management of struma ovarii, its associated complications, and postoperative follow-up and investigations. We retrospectively reviewed cases of benign struma ovarii treated at KK Women's and Children's Hospital, Singapore, between January 2000 and May 2011. A total of 68 patients underwent surgical removal of ovarian cyst or mass (24 cystectomy, 20 salpingo-oopherectomy and 24 total hysterectomy and bilateral salpingo-oopherectomy). Of the 68 surgeries, 39 (57.4%) included intraoperative frozen section sampling or procedures for staging of ovarian malignancy. The majority (73.5%) of surgeries were laparotomies. Histology revealed benign struma ovarii in all (98.5%) but one patient. Only 7 (10.3%) patients had postoperative complications - 3 wound-related, 2 thyroid-related, 1 incisional hernia and 1 nonspecific. The mean length of hospital stay was 4.2 days. During follow-up, 45 (66.2%) patients required no additional investigations. The most common investigation done was ultrasonography (n = 18, 26.5%). While no recurrences were diagnosed histologically, two patients were subsequently found to have complex/dermoid ovarian cysts on the ipsilateral side of the previous struma ovarii on ultrasonography. Simple surgery is recommended for patients with struma ovarii, especially if they have fertility potential. Laparoscopic surgery is the recommended approach due to its shorter recovery time and lower morbidity. Most patients do not require extended periods of follow-up or postoperative investigations.