OP07.04: Two cases of struma ovarii with initial ultrasonographic diagnosis of malignant ovarian tumour

In the first case, a 70-year-old woman presenting abdominal pain, asthenia, weight loss and disturbed bowel habit was referred due to finding of right adnexal lesion on CT scan. Transvaginal ultrasound showed solid tumour 42x39x40mm with cystic areas, irregular wall shadowing, colour score 3, unclassifiable by IOTA Simple Rules.In second pelvic incidental mass diagnosed sonography in 68-year-old woman. retro-uterine multilocular cyst 73x39x77mm > 5 locules, low-level echogenicity fluid, wall, probably ovarian origin. Largest component 20x28mm, 4. Ascites present. It classified as malignant Rules. both cases, diagnosis suggested an expert examiner malignant; scan immature teratoma. Tumour markers were negative. The two patients underwent bilateral adnexectomy via laparoscopy. Final anatomopathological diagnoses Struma ovarii no atypia. One most characteristic sonographic features struma –although not seen cases we present– is pearls: well defined smooth roundish areas tissue, similar white ball sebum dermoid cysts, but central vascularisation case ovarii. published series, components moderate are visualised. Almost all present or anechogenic content. Commonly they have more than internal walls papillary projections. may be found – sometimes pleural effusion (pseudo-Meig's syndrome). infrequently pre-operatively since its heterogeneous appearance low incidence often lead misclassification. existing experienced examiners tend classify them uncertain about malignancy.