Struma ovarii is an uncommon ovarian tumour, defined by the finding of thyroid tissue in the ovary, and more frequently found in teratomas. Symptoms of struma ovarii are nonspecific. The definite diagnosis is made by histological examination. The authors report the case of an asymptomatic 76-year-old female patient, whose ultrasonography, magnetic resonance and computed tomography suggested bilateral ovarian teratoma. Risk of Ovarian Malignancy Assessment score was high. She underwent exploratory laparotomy, peritoneal washing, total hysterectomy, bilateral adnexectomy and intra-operative frozen section. The final pathological report described bilateral mature cystic teratoma with benign struma ovarii. Surgery remains the best treatment.
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