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Uncommon tumor with rare variant: Cystic struma ovarii – A case report with review of literature

Struma ovarii is a very unusual and rare type of monodermal teratoma presenting as a solid pelvic mass. Struma ovarii concurrently occurring with cystic variant is rarely reported. To the best of our knowledge, only 4–5 cases of cystic struma ovarii have been reported in the past two decades. In exceptionally rare cases, it can be malignant. We present an ovarian teratoma which was grossly partially solid and partially cystic filled with mucoid content, causing the diagnosis of struma ovarii to be unnoted. There may be the source of many diagnostic problems if the microscopic examination showed flattened cystic wall with entrapped minimal thyroid follicles in counterpoint to struma ovarii resulting in confusion with other cystic ovarian tumors. No other component of mature teratoma was found in the present case. Presence of a few thyroid follicles and flattened epithelial lining needs extensive sampling and immunohistochemical staining for thyroglobulin and thyroid transcription factor-1 to establish an exact diagnosis. The aim of this literature is to delimitate cystic struma ovarii rarity and for the diagnostic dispute encountered.