Fig. 7
Benign cystic struma ovarii in an 81-year-old woman, presenting with abdominal swelling and discomfort and normal CA125. a Ultrasound shows thick septations (arrow) within a cystic lesion. Three-tesla T2-weighted high-resolution images (b), unenhanced (c) and enhanced (d) T1 fat-saturated LAVA, diffusion-weighted images b = 1,200 mm/s2 (e) and corresponding ADC map (high ADC values shown in red) (f) through the same slice are shown. The case macroscopically mimicked a cystadenoma. g On histological examination, however, although the cyst loculi were lined by flattened low columnar indifferent epithelium, there were several small areas where micro- and macro-follicles of thyroid tissue were evident. The diagnosis was confirmed with the aid of positive immunostaining for both thyroglobulin (h) and TTF1 antibodies. No other teratomatous component was identified despite review of the tissue blocks