Struma ovarii physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Patients with Struma ovarii usually appear normal. Physical examination of patients with Struma ovarii is usually remarkable for palpable lower abdominal mass. Pelvic pressure related to a pelvic mass is observed. Struma ovarii appears to occur more frequently in the right adnexa. In some cases ascites may be observed.

Physical Examination

  • Physical examination of patients with Struma ovarii is usually remarkable for:
  • Palpable lower abdominal mass
  • Pelvic pressure related to a pelvic mass
  • Struma ovarii appears to occur more frequently (68.8%) in the right adnexa and CA-125 level appears within normal limits. [1]
  • Clinical features in struma ovarii are generally non-specific and resemble ovarian malignancy. [2]
  • Pre-operative radiological diagnosis is essential inorder to avoid ovarian cancer type surgery (bilateral salpingo-oophorectomy, hysterectomy, omentectomy and occasionally appendectomy). [2]
  • Advanced MRI may be helpful in identifying and to determine the unusual ovarian mass. [2]
  • Occasionally Struma ovarii may present as a purely cystic lesion. [2]

Appearance of the Patient

  • Patients with Struma ovarii usually appear asymptomatic and some may experience discomfort in the abdomen due to pelvic pressure related to a pelvic mass.

Vital Signs

  • Vital signs in a patient with Struma ovarii appear to be normal.

Skin

There are no significant findings associated with Struma ovarii.

HEENT

  • There are no significant findings associated with Struma ovarii.

Neck

  • There are no significant findings associated with Struma ovarii.

Lungs

  • In malignant struma ovarii, distant metastases to the lungs have been observed. [3]
  • In some cases of Struma ovarii, hydrothorax has been observed. [4]

Heart

Abdomen

  • Palpable lower abdominal mass
  • May present with ascites in some cases. [5]

Back

There are no significant findings associated with Struma ovarii.

Genitourinary

  • A pelvic mass may be palpated
  • Pelvic pressure related to a pelvic mass

Neuromuscular

There are no significant findings associated with Struma ovarii.

Extremities

There are no significant findings associated with Struma ovarii.

References

  1. Zalel Y, Seidman DS, Oren M, Achiron R, Gotlieb W, Mashiach S, Goldenberg M (2000). "Sonographic and clinical characteristics of struma ovarii". J Ultrasound Med. 19 (12): 857–61. PMID 11127011.
  2. 2.0 2.1 2.2 2.3 Dujardin MI, Sekhri P, Turnbull LW (2014). "Struma ovarii: role of imaging?". Insights Imaging. 5 (1): 41–51. doi:10.1007/s13244-013-0303-3. PMC 3948908. PMID 24357453.
  3. Selvaggi F, Risio D, Waku M, Simo D, Angelucci D, D'Aulerio A, Cotellese R, Innocenti P (2012). "Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report". World J Surg Oncol. 10: 93. doi:10.1186/1477-7819-10-93. PMC 3586957. PMID 22613573.
  4. 4.0 4.1 Yoo SC, Chang KH, Lyu MO, Chang SJ, Ryu HS, Kim HS (2008). "Clinical characteristics of struma ovarii". J Gynecol Oncol. 19 (2): 135–8. doi:10.3802/jgo.2008.19.2.135. PMC 2676458. PMID 19471561.
  5. 5.0 5.1 Tanimanidis P, Chatzistamatiou K, Nikolaidou A, Kaplanis K (2014). "Struma ovarii. A case report". Hippokratia. 18 (4): 357–8. PMC 4453812. PMID 26052205.

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