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卵巢甲状腺肿(struma ovarii，SO)发病率较低，占卵巢畸胎瘤的5%~15%，巨大SO、胸腹腔积液伴糖抗原125升高者罕见，其诊断和治疗尚无完善的临床治疗指南。SO患者的MRI呈“黑珍珠”样表现，手术方式可选择附件切除术，术后病理可确诊，预后大多良好。“,”The incidence of struma ovarii(SO) is low, accounting for 5% to 15% of ovarian teratoma.Huge SO, pleural effusion and ascites with elevated carbohydrate antigen 125 are rare.There is no perfect clinical treatment guideline for the diagnosis and treatment of SO.MRI of patients with SO showed “ Black Pearl” appearance.Appendectomy can be selected as the operation method.Postoperative pathology can confirm the diagnosis, and the prognosis is good.