A case of struma ovarii with coexistent Brenner tumor presenting with thyrotoxicosis

Abstract

ABSTRACT Struma ovarii is an ovarian tumor, characterized by the presence of thyroid tissue comprising >50% of the overall mass. Although struma ovarii does not usually secrete thyroid hormones, there are cases in which it produces thyroid hormones, which results in hyperthyroidism. Here, we report the case of a 73-year-old female who presented with a right ovarian mass and symptoms suggestive of thyrotoxicosis. Her thyroid function test showed suppressed thyroid-stimulating hormone and elevated T3 and T4 levels. We suspected thyroiditis initially. Later, in view of persistent thyrotoxicosis, she was started on antithyroid drugs. Tc99 pertechnetate thyroid uptake scan showed absent uptake in the neck. A possibility of struma ovarii was considered. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathology revealed >80% thyroid tissue suggestive of struma ovarii with a coexistent Brenner tumor. Postoperatively, her thyrotoxicosis got resolved. To conclude, in any case of thyrotoxicosis that is persisting and with absent uptake in the neck, rare cases such as struma ovarii should be considered. Struma ovarii with a coexistent Brenner tumor is a very rare finding.