Search Our Scientific Publications & Authors

Folia Histochem Cytobiol 2019 29;57(1):35-42. Epub 2019 Mar 29.

Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.

Introduction: Struma ovarii (SO) is a monodermal teratoma in which thyroid tissue comprises more than 50% of the tumour. Papillary thyroid cancer (PTC) in SO is a rare finding, as only 5% of SO cases undergo malignant transformation. Malignant SO is usually asymptomatic and infrequently diagnosed preoperatively. Read More

J Obstet Gynaecol 2019 Mar 16:1-2. Epub 2019 Mar 16.

a Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon.

J Midlife Health 2018 Oct-Dec;9(4):225-229

Department of Radio-Diagnosis, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Struma ovarii is a variant of mature cystic teratoma, with predominant thyroid element. Confirmatory diagnosis is by histopathology. It may mimic as ovarian malignancy in some. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13867

Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Rationale: Malignant struma ovarii is extremely rare in the clinic. The diagnosis and modalities of treatment are still controversial. Here we describe a case of extensive peritoneal implant metastasis originating from malignant struma ovarii discovered 14 years after ovariectomy and chemotherapy. Read More

Diagn Cytopathol 2019 Mar 28;47(3):218-221. Epub 2018 Nov 28.

Department of Pathology and Laboratory Medicine, Kansai Medical University, Hirakata, Japan.

Strumal carcinoid is a rare ovarian tumor defined as carcinoid associated with struma ovarii. We report here the second cytological case of strumal carcinoid and performed immunocytochemical analysis for the first time. A 68-year-old Japanese female was found to have a solid tumor with small cystic components in the left ovary, and bilateral salpingo-oophorectomy was performed. Read More

Case Rep Oncol 2018 Sep-Dec;11(3):693-698. Epub 2018 Oct 31.

Department of Gynecology and Obstetrics, Tagawa Municipal Hospital, Fukuoka, Japan.

Introduction: Malignant struma ovarii is a rare neoplasm. It is usually asymptomatic and not commonly diagnosed preoperatively. In addition, there is currently no established diagnostic and therapeutic approach for malignant struma ovarii. Read More

Clin Nucl Med 2019 Jan;44(1):42-44

Institute of Pathology, Essen University Hospital, Essen, Germany.

A 67-year-old woman presented with malignant struma ovarii after radical bilateral salpingo-oophorectomy. The surgery revealed a 4.4 cm papillary thyroid carcinoma (follicular variant) within a right-sided ovarian teratoma. Read More

Am J Forensic Med Pathol 2019 Mar;40(1):89-93

Department of Clinical Pathology, ASL 1 Imperiese - Sanremo Hospital, Sanremo, Italy.

Meigs syndrome is the triad of ascites, hydrothorax, and benign ovarian tumor (mostly fibroids). It is a diagnosis of exclusion, and the characteristic symptoms disappear after resection of the tumor. Instead, in Pseudo-Meigs syndrome, the triad includes a nonfibroma ovarian tumor. Read More

Zhonghua Bing Li Xue Za Zhi 2018 Sep;47(9):733-736

Int J Surg Case Rep 2018 5;51:218-220. Epub 2018 Sep 5.

Pathology Department, Ardabil University of Medical Sciences, Ardabil, Iran.

Introduction: Struma ovarii is an ovarian tumor with thyroid tissue as its predominant component. It usually occurs in older women and presents with abdominal mass, pain and abnormal bleeding. Most patients are euthyroid, but some reports have noted thyrotoxicosis originating from the malignant struma ovarii. Read More

Med Ultrason 2018 Aug;20(3):355-361

Department of Gynecology and Obstetrics Charles University in Prague-First Faculty of Medicine and Hospital Na Bulovce, Czech Republic.

Aims: To describe the ultrasound features of benign struma ovarii that often mimic ovarian cancer in the background of complex clinical and histopathological pictures.

Material And Methods: We retrospectively identified patients with histologically confirmed benign struma ovarii, treated in our institution between 2003-2016 with complete imaging, clinical, nd histopathological data available. Ultrasound findings were drawn from images, and reports using terms and definitions of the International Ovarian Tumor Analysis group and pattern recognition description was applied. Read More

J Reprod Infertil 2018 Jul-Sep;19(3):174-181

Department of Assisted Reproduction, Hospital Quironsalud Malaga, Malaga, Spain.

Background: Cryopreservation of oocytes is an efficient method of fertility preservation (FP) that can be applied in women suffering from gynecologic conditions that menace their reproductive future. Collection of oocytes becomes challenging in some scenarios, like the possibility of an ovarian cancer, the "" harvest of oocytes for FP, aspirating follicles directly from the ovarian specimen already excised by laparotomy or laparoscopy and it is an option for these cases.

Case Presentation: In the present case report, the case of a patient with an adnexal mass suspected to be a recurrent teratoma was described who referred to our Assisted Reproduction Unit in Hospital Quironsalud Malaga for FP counseling. Read More

Int J Gynecol Pathol 2018 Aug 21. Epub 2018 Aug 21.

Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry (S.S.) Department of Pathology (W.G.M.), Belfast Health and Social Care Trust, Belfast, Northern Ireland UK.

Brenner tumors are uncommon ovarian neoplasms which occasionally occur in combination with a mucinous tumor. Rarely, the combination of Brenner tumor and thyroid tissue (struma ovarii) has been reported. We report an ovarian neoplasm with components of Brenner tumor, mucinous cystadenoma and struma ovarii. Read More

J Endocr Soc 2018 Aug 10;2(8):944-948. Epub 2018 Jul 10.

Department of Medicine, Endocrinology Section, MedStar Washington Hospital Center, Washington, DC.

Struma ovarii is a rare ovarian teratoma predominantly composed of thyroid tissue. The simultaneous presence of thyroid carcinoma in the struma ovarii and the thyroid gland is extremely rare. It remains unclear if these carcinomas represent independent primary tumors and whether the molecular mechanisms of the tumors developing in the thyroid and ovarian tissues are similar. Read More

Thyroid Res 2018 24;11:10. Epub 2018 Jul 24.

1Department of General Surgery, Hamad General Hospital, Doha, Qatar.

Background: Malignant struma ovarii (MSO) is a very rare, germ cell tumor of the ovary, histologically identical to differentiated thyroid cancers. Struma ovarii (SO) is difficult to diagnose on clinical basis or imaging and is mostly discovered incidentally, with few published cases in the literature.

Case Presentation: A 42-year old primiparous woman presented with abdominal pain and midline pelvic palpable firm mass arising from the pelvis. Read More

Zhonghua Bing Li Xue Za Zhi 2018 Jul;47(7):517-521

Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology; Shanghai Medical College, Fudan University, Shanghai 200032, China.

To describe the clinicopathologic features, diagnosis and differential diagnosis of ovarian carcinoid tumors. A retrospective chart review was performed of all patients diagnosed with primary ovarian carcinoid tumors at Fudan University Shanghai Cancer Centre from 2007 to 2017. The histologic analysis of these carcinoid tumors revealed 3 were insular, 1 was trabecular, 1 was mucinous, and 10 were strumal. Read More

Clin Diabetes Endocrinol 2018 19;4:13. Epub 2018 Jun 19.

4Department of Nuclear Medicine, University of Michigan, 1500 E Medical Center Dr, B1G505, Ann Arbor, MI 48109-5028 USA.

Background: Malignant struma ovarii is an ovarian teratoma containing at least 50% thyroid tissue which has the potential to metastasize and produce thyroid hormone. Given its rarity, management strategies are not well-established. We report a case of metastatic malignant struma ovarii discovered during pregnancy with lessons for evaluation and management. Read More

Anticancer Res 2018 Jun;38(6):3669-3675

Department of New Technologies and Translational Research, Division of Pathology, University of Pisa, Pisa, Italy.

Malignant transformation occurs in 1.5-2% of mature cystic teratomas (MCT)s of the ovary and usually consists of squamous cell carcinoma, whereas other malignancies are less common. Diagnosis and treatment represent a challenge for gynecologic oncologists. Read More

JBJS Case Connect 2018 Apr-Jun;8(2):e35

Zhonghua Bing Li Xue Za Zhi 2018 May;47(5):339-343

Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

To study the clinicopathologic feature, diagnostic strategy and prognostic significance of primary carcinoid of the ovary (PCOTO). A series of 17 patients previously diagnosed as PCOTO at Department of Pathology, Peking Union Medical College Hospital during the period from 2002 to 2017 were evaluated with clinical data analysis, histopathology and immunohistochemistry, and the patients were followed up and the relevant literatures were reviewed. The age of patients ranged from 24 to 64 years (mean, 42 years). Read More

Gynecol Oncol Rep 2018 May 19;24:87-89. Epub 2018 Apr 19.

Division of Gynecologic Oncology, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, United States.

•Peritoneal strumosis is highly differentiated thyroid follicular carcinoma of ovarian origin.•Minimally invasive surgical techniques for peritonectomy can resect extra-ovarian disease.•Multi-disciplinary collaboration allowed avoidance of thyroid ablation and thyroidectomy. Read More

Bull Cancer 2018 Mar 17;105(3):281-289. Epub 2018 Feb 17.

Institut Bergonié, département de médecine nucléaire et de cancérologie thyroidienne, 229, cours de l'Argonne, 33076 Bordeaux, France.

Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumour, derivate from monodermic teratomas. It represents about 0.01% of overall ovarian tumours and 5 to 10% of struma ovarii. Read More

Virchows Arch 2018 Aug 17;473(2):177-182. Epub 2018 Feb 17.

Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, 5 Zaifu, Hirosaki, 036-8562, Japan.

Although ovarian monodermal teratomas, including struma ovarii and carcinoids, are closely associated with mature teratomas, their genetic basis is poorly understood. A series of mature and monodermal ovarian teratomas were analyzed by short tandem repeat genotyping to evaluate their genetic zygosity and its associations. Informative DNA genotyping data were obtained for ten mature teratomas, six struma ovarii, and three carcinoids (one insular, one trabecular, and one mucinous). Read More

J Ovarian Res 2018 Feb 2;11(1):11. Epub 2018 Feb 2.

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.

Background: Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. Pseudo-Meigs' syndrome with ascites, pleural effusion, and elevated serum CA 125 levels is much rarer and leads to misdiagnosis of ovarian cancer and unnecessary extended surgery.

Case Presentation: A 50-year-old woman with abdominal distention and dyspnoea was referred to our hospital. Read More

Medicina (B Aires) 2018;78(1):44-46

Servicio de Endocrinología, Servicio de Endocrinología y Metabolismo, Complejo Médico Churruca-Visca, Buenos Aires, Argentina.

Hyperthyroidism is defined as an excessive production of thyroid hormones by eutopic or ectopic mature thyroid tissue. The overall prevalence of hyperthyroidism is 1.2% and the most common cause is Graves' disease. Read More

Gynecol Endocrinol 2018 Jul 10;34(7):558-562. Epub 2018 Jan 10.

a Gynecology and Physiopathology of Human Reproductive Unit , University of Bologna, S. Orsola-Malpighi Hospital of Bologna , Bologna , Italy.

In this case report, the outcomes of cryopreserved ovarian tissue transplantation performed in a patient affected by struma-ovarii associated with mature cystic teratoma, recurrent endometriotic cysts and diffuse peritoneal malignant struma-ovarii implants were described. Before cryopreservation, the patient underwent two left ovarian surgeries for enucleation cysts 8 years after righ salpingo-oophorectomy for struma-ovarii. Ovarian biopsy was collected in another hospital and transported to our laboratory for cryopreservation. Read More

J Radiol Case Rep 2017 Jul 31;11(7):20-30. Epub 2017 Jul 31.

Serviço de Anatomia Patológica, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.

We describe a case of a mature cystic teratoma of the ovary with high proportion of solid thyroid tissue (< 50% of the entire tumor) in a childbearing woman. The patient presented with non-specific abdominal bloating. Pelvic ultrasound and magnetic resonance imaging revealed a complex cystic-solid tumor confined to the left ovary with an anterior fat-containing locus compatible with mature cystic teratoma and a posterior predominantly solid component with low signal intensity on T2-weighted images that was histopatologically diagnosed as benign thyroid tissue. Read More

JBJS Case Connect 2017 Oct-Dec;7(4):e82

Departments of Orthopaedic Oncology (J.C., F.F.E.P., S.A.N., and W.T.C.), and Pathological Anatomy (F.D.C. and A.D.B.), AC Camargo Cancer Center, São Paulo, Brazil.

Case: We report the case of a 38-year-old woman who presented with a lytic bone lesion in the left scapula. A biopsy showed a tumor with the histologic appearance of thyroid tissue. She also was found to have a thyroid nodule and an enlarged ovary, both of which were excised. Read More

Hormones (Athens) 2017 Jul;16(3):322-327

Unit of Nuclear Medicine, Centro di Riferimento Oncologico, IRCCS-National Cancer Institute, Aviano, PN Italy.

Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Read More

J Endocr Soc 2017 May 23;1(5):396-400. Epub 2017 Mar 23.

Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215.

Context: The presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries is rare, and usually incidentally found on surgical pathology specimens. We present a case of simultaneous intrathyroidal thyroid cancer and thyroid cancer within a struma ovarii, presenting specific diagnostic challenges.

Case Description: A 55-year-old woman had an intrathyroidal, encapsulated 1. Read More

Rom J Morphol Embryol 2017 ;58(3):1035-1040

Department of Obstetrics and Gynecology, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania;

Strumal carcinoid represents a rare form of ovarian teratoma, consisting of both thyroid tissue and carcinoid structures. The carcinoid component is a well-differentiated neuroendocrine tumor with excellent prognosis. Strumal carcinoid tumors are commonly found in peri-menopausal women who are not usually interested in preserving their fertility and who are thus open to radical surgical treatment. Read More

J Minim Invasive Gynecol 2018 Sep - Oct;25(6):941-943. Epub 2017 Dec 6.

Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea. Electronic address:

Ann Pathol 2017 Dec 21;37(6):479-483. Epub 2017 Nov 21.

Service d'anatomie et cytologie pathologiques, hôpital de la Timone, 254, rue Saint-Pierre, 13005 Marseille, France.

We report the case of a 33-year-old woman who went under surgery for a cystic mature teratoma. The histological exam found two cysts, one was a mature teratoma and the other was a struma ovarii with a papillary carcinomatous element. Struma ovarii cancerization is seen in 5 to 10% of the cases usually under a papillary carcinoma type. Read More

Endocrinol Diabetes Metab Case Rep 2017 13;2017. Epub 2017 Oct 13.

Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.

We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion.

Learning Points: It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy. Read More

Int J Surg Case Rep 2017 14;40:113-115. Epub 2017 Sep 14.

Dept. of Medicine, University Jaume I (UJI), Castellon de la Plana, Spain.

Introduction: Struma ovarii is a rare ovarian tumor, representing 0.5-1% of all ovarian tumors and 2-5% of ovarian teratomas. It is defined as an ovarian teratoma composed mostly of thyroid tissue. Read More

J Adolesc Young Adult Oncol 2018 02 31;7(1):134-136. Epub 2017 Jul 31.

1 Department of Gynecology and Obstetrics, Antalya Training and Research Hospital, Sağlık Bilimleri University , Antalya, Turkey .

Ovarian tumors presented with ovarian mass in childhood and adolescence are uncommon but an important part of gynecological cases. Struma ovarii is one of the rare cystic benign ovarian tumors that is observed predominantly in women who are between the ages of 40 and 60 years old. It is extremely rare in adolescents. Read More

Sultan Qaboos Univ Med J 2017 May 20;17(2):e229-e233. Epub 2017 Jun 20.

Department of Obstetrics & Gynecology, Lok Nayak Jai Prakash Narayan Hospital, New Delhi, Delhi, India.

The monodermal teratoma is a rare ovarian tumour; however, presenting with pseudo-Meigs' syndrome and raised cancer antigen (CA)-125 levels is even rarer. In elderly patients, this presentation can potentially lead to a misdiagnosis of a malignant ovarian carcinoma, resulting in unnecessary extensive surgery. We report a 55-year-old female who presented to the Lok Nayak Jai Prakash Narayan Hospital, New Delhi, India, in 2016 with progressive abdominal discomfort, fatigue and abdominal distention. Read More

Pan Afr Med J 2017 25;26:223. Epub 2017 Apr 25.

Faculté de Médecine et de Pharmacie, Université Mohammed V Souissi, Rabat Maroc.

Struma ovarii is a rare tumor, which accounts for 2.7% of ovarian teratomas and 0.01% of ovarian tumors. Read More

Clin Med Insights Endocrinol Diabetes 2017 6;10:1179551417712521. Epub 2017 Jun 6.

Clínica de Endocrinología y Metabolismo, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

Mature cystic teratoma is the most common kind of ovarian germ cell tumor. Malignant transformation is uncommon, with thyroid cancer rarely found. Papillary thyroid microcarcinoma has rarely been described as associated with ovarian teratomas. Read More

Thyroid Res 2017 30;10. Epub 2017 May 30.

Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS Canada.

Background: Struma ovarii is a rare monodermal germ cell tumor where the ovary is comprised of at least half thyroid tissue. This phenomenon may indicate an embryological origin.

Case Presentation: A 30-year old nulliparous woman presented with acute right lower quadrant pain and underwent laparoscopic right salpingo-oophorectomy. Read More

Nucl Med Mol Imaging 2017 Jun 7;51(2):198. Epub 2017 Mar 7.

Department of Otorhinolaryngology-Head and Neck Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

[This corrects the article DOI: 10.1007/s13139-016-0459-0.]. Read More

Endocrinol Diabetes Nutr 2017 Feb 1;64(2):121-122. Epub 2017 Feb 1.

Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.

Clin Nucl Med 2017 Jun;42(6):475-477

From the *Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, †Nuclear Medicine, Department of Radiology, and ‡Department of Pathology, University of Michigan, Ann Arbor, MI.

We report the case of a 61-year-old woman with persistent thyrotoxicosis for 7 years despite low thyroidal radioiodine uptake and methimazole treatment. Her initial I whole-body scan (WBS) was read as negative. Upon evaluation in our institution, she remained hyperthyroid after discontinuation of methimazole. Read More

Acta Clin Croat 2016 06;55(2):265-70

Ljudevit Jurak Clinical Department of Pathology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

Teratomas are tumors derived from germ cells, most frequently arising in the gonads. The aim of this study was to determine the number of ovarian teratomas diagnosed in the routine biopsy material at Ljudevit Jurak Clinical Department of Pathology, Sestre milosrdnice University Hospital Center during a 5-year period, as well as their clinical, gross and microscopic characteristics. Teratomas accounted for 48. Read More

J Endocrinol Invest 2017 06 1;40(6):687-688. Epub 2017 Mar 1.

Endocrine Unit, Tinchi Hospital, Matera, Italy.

J Adolesc Young Adult Oncol 2017 Jun 13;6(2):270-276. Epub 2017 Jan 13.

Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital , Ankara, Turkey .

Purpose: To validate the oncological safety of fertility preservation in malignant ovarian germ cell tumors (MOGCTs) and to define the significance of maximal cytoreduction in early stage MOGCTs.

Materials And Methods: Sixty-nine patients with stage I and II MOGCTs who underwent surgical treatment were included in the study. Fertility-sparing surgery is defined as conservative surgery and hysterectomy and contralateral salpingo-oophorectomy were defined as definitive surgery. Read More

Gynecol Minim Invasive Ther 2017 Jan-Mar;6(1):28-30. Epub 2016 Jun 11.

Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.

We report struma ovarii in a case that had hyperthyroidism and was treated with laparoscopic tumor resection. A 40-year-old Japanese woman presented with tachycardia, finger tremor, and weight loss. Although blood examination showed hyperthyroidism, test results for thyroid stimulating hormone receptor antibody and thyroid stimulating antibody were negative, and thyroid scintigraphy showed no abnormal findings. Read More

Nucl Med Mol Imaging 2016 Dec 11;50(4):353-357. Epub 2016 Nov 11.

Department of Otorhinolaryngology-Head and Neck Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

A 52-year-old woman diagnosed with papillary thyroid carcinoma was referred for I therapy following total thyroidectomy. She was given 4,810 MBq (130 mCi) of I following 4 weeks of thyroid hormone withdrawal. A posttherapy scan showed intense, focal activity in the pelvis and intense, diffuse activity on both sides of the chest, which was localized to the right ovary and both breasts on SPECT/CT examination. Read More

Case Rep Oncol Med 2016 2;2016:2643470. Epub 2016 Nov 2.

Department of Medicine, ABC Medical Center, Mexico City 01120, Mexico; Neurological Center, ABC Medical Center, Mexico City 01120, Mexico.

Struma ovarii is a rare monodermal variant of ovarian teratoma that contains at least 50% thyroid tissue. Less than 8% of struma ovarii cases present with clinical and biochemical evidence of thyrotoxicosis due to ectopic production of thyroid hormone and only 5% undergo malignant transformation into a papillary thyroid carcinoma. Only isolated cases of hormonally active papillary thyroid carcinoma developing within a struma ovarii have been reported in the literature. Read More

Eur Thyroid J 2016 Sep 8;5(3):207-211. Epub 2016 Sep 8.

Department of Pathology, Alexandra General Hospital, Athens, Greece.

Background: Struma ovarii (SO) is a specialized monodermal teratoma predominantly composed of mature thyroid tissue, accounting for approximately 5% of all ovarian teratomas. Thyrotoxicosis is seen in about 8% of patients with SO. Most SO cases are benign with only 5-10% being malignant, and malignant SO causing thyrotoxicosis is very uncommon. Read More