Abstract #1412915: Malignant Struma Ovarii - A Rare Disease with Unpredictable Nature and Treatment Option Controversies

Struma ovarii is a rare kind of ovarian teratoma which consists >50% thyroid tissue. It contributes to 2-5% all teratomas. 5-10% teratomas undergo malignant transformation. To date, due its rarity, unpredictable nature and high recurrence rate no consensus have been reached regarding the optimal treatment strategy. Therefore, it prudent highlight this disease management as sharing experiences will further expand accruing data helps in reaching 42-year-old lady presented clinic with missed periods. She had weight loss hyper or hypo thyroidism related symptoms. Her ultrasound pelvis revealed left cyst MRI showed dermoid cyst. underwent oophorectomy whose biopsy struma having papillary carcinoma, FIGO stage 1a BRAF V600 mutation was present. function test, scan, CT chest abdomen were normal. staging laprotomy, right salphingo-oophorectomy, salphingectomy total hystrectomy biospy Subsequently thyroidectomy done <1cm low grade carcinoma involving lobe gland, pT1a, Nx, Mx. stimulated thyroglobulin antithyroglobulin antibody 6 weeks postop neck kept on replacement thyroxine doses. Malignant presents abdominal pain, menstrual irregularity, bloating, mass ascites. At times may be asymptomatic. Thyroid symptoms are not frequent. Studies demonstrated good survival ovarii. However, clinical course remains relatively frequency recurrences metastasis irrespective morphology poses difficulty selection. Mostly aggressive approach including hystrectomy, bilateral followed by radioactive iodine therapy TSH suppressive doses adapted. Though some prefer less approach. Due uncertain scanty management, still matter debate. Tumor size, molecular profiling histopathology proposed consider while stratifying risk selecting Moreover, vigilant followups should detect early so that timely intervention could done.