Struma ovarii

Struma ovarii is a rare ovarian tumor that is composed entirely or predominantly of thyroid tissue. They constitute approximately 3% of all ovarian teratomas, 2% of all germ cell tumors of the ovary, and 0.5% of all ovarian tumors. Only about 5% of struma ovarii is malignant.

Suspicion of struma ovarii arises when a multilocular–solid adnexal mass containing one or more ‘struma pearls’ is seen (Savelli et. al, 2008).

Struma pearl
Case 1: 9cm ovarian cyst containing hypoechogenic fluid and the characteristic ‘struma pearl’ on the top left corner.
Struma ovarii ultrasound pearl
Case 2: 6.5cm multilocular cyst with struma pearl.
Case 2: Video of the same case.


  • Savelli, L., Testa, A. C., Timmerman, D., Paladini, D., Ljungberg, O. and Valentin, L. (2008), Imaging of gynecological disease (4): clinical and ultrasound characteristics of struma ovarii. Ultrasound Obstet Gynecol, 32: 210–219. doi:10.1002/uog.5396

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