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Metastatic follicular carcinoma arising from struma ovarii
  1. Jia Deng1,
  2. Yang Huang Grace Ng2,
  3. Sung Hock Chew3 and
  4. Yong Kuei Lim4
  1. 1Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
  2. 2Obstetrics & Gynaecology, Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
  3. 3Pathology & Laboratory Medicine, KK Women's and Children's Hospital, Singapore
  4. 4Obstetrics & Gynaecology, Gynaecological Oncology, KK Women's and Children's Hospital, Singapore
  1. Correspondence to Dr Jia Deng; jia.deng{at}


Struma ovarii (SO) is an uncommon monodermal teratoma predominantly composed of mature thyroid tissue. Approximately 5% of SO are malignant; however, metastases are rare. A single female in her 40s, with a medical history of Graves’ disease and bilateral cystectomy 10 years prior for right endometriotic cyst and left SO, presented with an enlarging abdominal mass for 4 months. Ultrasound pelvis showed a 13.8 cm left adnexal heterogeneous solid-cystic mass with internal septations and vascularity. She underwent open left salpingo-oophorectomy and resection of fibrous nodules from the right infundibulo-pelvic ligament and fallopian tube. Histology showed highly differentiated metastatic follicular carcinoma. She subsequently underwent total thyroidectomy, total hysterectomy, right salpingo-oophorectomy, tumour debulking and omentectomy followed by radioactive iodine treatment. Four-year follow-up did not show tumour recurrence or metastases. Due to its rarity, there are no well-established guidelines for the management and follow-up of metastatic follicular carcinoma arising from SO.

  • Obstetrics and gynaecology
  • Gynecological cancer

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  • Contributors YHGN and YL conceived of the presented idea. JD drafted the manuscript. SHC reviewed and obtained the histological slides. YHGN, SHC and YL reviewed the manuscript drafts. All authors contributed and gave final approval to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.