Giant struma ovarii with pseudo-Meigs’syndrome and raised cancer antigen-125 levels: A case report

Figure 1 Transvaginal ultrasound images. A: Transvaginal ultrasound (US) demonstrating a large (12.8 cm × 8.0 cm), solid, cystic mass, originating in the right ovary and a small (2.8 cm × 2.1 cm), solid left adnexal mass; B: US showing a large amount of free peritoneal fluid and thickened greater omentum.

Figure 2 Computed tomography scan imaging of the chest and pelvis. A: Computed tomography (CT) scan of the chest revealing right lung atelectasis with a large right pleural effusion; B: CT scan of the pelvis showing gross ascites and a large complex cystic pelvic mass.

Figure 3 Hematoxylin-eosin staining and immunohistochemistry of percutaneous biopsy of the pelvic mass. A: Hematoxylin-eosin staining showed multiple benign colloid-filled thyroid follicles (× 200); B-D: Immunohistochemistry (IHC) examination revealed that pelvic mass was positive for thyrobolulin (× 200), thyroid transcription factor-1 (× 200) and Cytokeratin-7 (× 200), respectively; E-L: IHC examination revealed that pelvic mass was negtive for Cytokeratin-20 (× 200), caudal-related homeobox transcription factor 2 (× 200), Estrogen receptor (× 200), calretinin (× 200), P53 (× 200), P16 (× 200), Wilms tumor-1 (× 200) and Ki-67 (× 200), respectively.

Figure 4 Histopathological analysis of the resected specimen. A: Hematoxylin-eosin stained left ovary showing teratoma (× 200); B: Microscopic appearance of the right ovary showing variable-sized thyroid follicles (× 200).