A Case of Struma Ovarii Enlarged during Pregnancy

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  • NAGAHARA Daijiro
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics and Gynecology, Saku Central Hospital
  • KOBARA Hisanori
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • KIKUCHI Norihiko
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • ANDO Hirofumi
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • YOKOKAWA Yusuke
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics, Nagano Child Hospital
  • ONO Motoki
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • TANAKA Yasuhiro
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • TAKEUCHI Hodaka
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • YAMADA Yasushi
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • MIYAMOTO Tsutomu
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • SHIOZAWA Tanri
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine

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Other Title
  • 妊娠中に増大した卵巣甲状腺腫の１例
  • ニンシン チュウ ニ ゾウダイ シタ ランソウ コウジョウセンシュ ノ 1レイ

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Abstract

Pregnancy complicated with struma ovarii is rare. We report a case of struma ovarii that enlarged during pregnancy. We also immunohistochemically investigated the expression of estrogen receptors (ER), progesterone receptors (PR), and thyroid stimulating hormone receptors (TSHR) in tumor cells to explore the mechanism of lesion enlargement.<br>A 30-year-old woman was diagnosed with right ovarian mature teratoma 4 cm in diameter using MRI five months before pregnancy. After she became pregnant, transvaginal ultrasonography revealed that the mass size was gradually increased. MRI examination was again performed at 14 weeks of gestation, which showed enlargement of the tumor to 5.5 cm in diameter, however, there was no apparent malignant finding. The clinical diagnosis was mature teratoma or struma ovarii of the right ovary. Laparoscopy-assisted ovarian cystectomy was performed at 15 weeks of gestation, and the pathological diagnosis of the removed tumor was struma ovarii. Immunohistochemical examination of the tumor demonstrated the positive expression of PR, but the expression of ER and TSHR was negative.<br>In the present case, the size of struma ovarii was increased during pregnancy, and this enlargement may be induced by pregnancy-related hormonal milieu via PR.

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