Vol. 2, Issue 2, Part B (2025)

Struma ovarii is a rare and specialized variant of ovarian teratoma composed predominantly of mature thyroid tissue. It represents approximately 1-5% of ovarian teratomas and less than 1% of all ovarian tumors. Although most cases are benign and asymptomatic, a small proportion may produce thyroid hormones leading to hyperthyroidism or undergo malignant transformation into papillary or follicular thyroid carcinoma. Struma ovarii usually occurs in women of reproductive age and is commonly unilateral. Clinical presentation varies from an incidental pelvic mass to pelvic pain, abdominal distension, menstrual irregularities, or thyrotoxic symptoms in functioning tumors. Diagnosis relies on imaging studies and laboratory findings, with confirmation by histopathology. Management primarily involves surgical excision, while malignant or metastatic cases may require thyroidectomy and radioactive iodine therapy. The prognosis is generally favorable, but long-term follow-up is recommended due to the risk of recurrence and rare complications.