Background: Struma ovarii is a rare ovarian neoplasm, which contains thyroid tissue. It accounts for less than 5% of ovarian teratomas. These are mostly benign, occurring between 40 years and 60 years of age. Clinical and radiological features are inconclusive and mostly it is diagnosed by histopathology. About 5-8% cases have hyperthyroidism. Cystic struma ovarii is very rare with only 25 cases reported till now. It creates confusion in diagnosis, as even in histopathology, the cells are mostly like those resembling other cystic ovarian tumors with minimal thyroid follicles. Case description: A 20-year-old girl came with complaints of abdominal discomfort and difficulty in squatting and lying supine. Clinically, a 28-week-size cystic tumor was palpated. Ultrasound showed features of a cystic benign tumor. Tumor markers were normal. Laparoscopic cystectomy was done. Histopathology showed cystic struma ovarii. At 6-month follow-up, the patient has been doing well. Conclusion: Cystic struma ovarii is a rare diagnosis. Clinical, biochemical, and radiological features do not help. A careful and keen pathological examination is necessary so that thyroid follicles are not left while viewing. There is no clear consensus on follow-up of these patients, but benign tumors usually do not need extensive follow-up. Clinical significance: It is a rare tumor and a good histopathological diagnosis is needed. Cystic tumors should be carefully examined. A proper correlation between clinical, biochemical, radiological, intraoperative, and histopathological findings may help us to consider this diagnosis when we get similar cases.

Background: Physiological changes in spiral arteries i.e. remodeling occur upto myometrial segment of the vessels and these changes are important for growth of the fetus. However in hypertensive pregnancies and IUGR, these changes are often not seen and arteries remain non-dilated. The aims of the study were to assess the extent of spiral vessel dilatation in hypertensive pregnancies and IUGR cases.Methods: Placental bed biopsy were taken in cases who underwent caesarean section and gave consent for the study, during the study period. 50 cases were included. Morphology and diameters of spiral arteries were assessed by histopathological examination. Arteries who retained the non-pregnant morphology were considered non-dilated and those who showed features of remodeling were considered normal. 14 cases were excluded as no vessel was seen in biopsy specimen. T-test and Chi-square tests were used for analysis. Out of the included 36 cases, percentage of non-dilated vessels was significantly high in gestational hypertension and preeclampsia(p=0.0230) and also significantly high in IUGR cases, (p=0.0113),irrespective of hypertension. Also the percentage of non-dilated vessels was higher in nulliparous women, though not significant.Placental bed biopsy specimens have limitations because they only provide information about a small segment of the placental bed. It is possible that areas close to the nonbiopsy site may have a completely different degree of vascular transformation. Moreover the number of cases in this study is less. Conclusion:Absence of spiral arterial remodeling is a crucial factor in hypertension in pregnancy and low birth weight babies. And adequate research is needed in this aspect so that such knowledge can help us to prevent hypertension in pregnancy and IUGR.

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