Primary endometrial squamous cell carcinoma is an extremely rare tumor which is usually seen in postmenopausal women with unclear pathogenesis. We report a case of postmenopausal woman with primary endometrial squamous cell carcinoma.

Introduction: - Ovarian sex cord-stromal tumours are rare, comprising only 8% percent of all primary ovarian tumours. Ovarian fibroma is the most common benign pure stromal tumour. It has no specific clinical manifestation, most of which are pelvic or adnexal masses. Case report: - This is 59 years old woman came to Orotta National Referral Maternity Hospital On 02-2-2023 with complaint of abdominal distension and pain of one-year duration. The distention progressed slowly and she lost weight profoundly which she can’t quantified despite having good appetite. Her menses stopped 15 years back, then-after she denies any history of vaginal bleeding or discharge. She had no any alteration in bowel habit but she experiences occasional shortness of breath especially when she sleeps without pillow. she was chronically sick looking, in mild distress with respiratory rate 20 breaths/minute with chest was clear to auscultation with decreased air entry on right lower lung field. Abdomen was grossly distended, shiny without visible collateral vein. On palpation, she had huge abdominopelvic mass of about 36 cm by 20 cm, hard, mobile, with rough surface and irregular border. Her haemoglobin was 12.82g/dl and platelet of 504.7x103/µL. Trans-abdominal ultrasonography showed huge solid pelvic mass with ascites and hydrothorax. The serum level of cancer antigen 125 (CA125) was 91.28 U/mL, the carcinoembryonic antigen (CEA) was 34.87 ng/mL and alpha-fetoprotein (AFP) and CA19-9 were within normal range. At laparotomy, there was ascites and a huge globular mass measuring 30 cm was observed on the left ovary. The right ovary, uterus, omentum, and pelvic lymph node were unremarkable macroscopically. Postoperative recovery was uneventful and histopathologic result revealed left Ovarian Fibrothecoma with benign endometrial polyp. Conclusion:- Ovarian fibrothecoma should be considered in women with pelvic pain and a large pelvic mass. In women with ascites and mildly elevated CA 125, the ovaries should be thoroughly investigated as they can be normal initially in imaging studies and gynaecological assessment. Radical surgical excision is the preferred treatment for postmenopausal women and is associated with a good prognosis.

Background: Pelvic fibromatosis or desmoids tumor is an uncommon benign mesenchymal tumor that usually involves the vulvo-vaginal area in women of reproductive age, which are slow growing and painless mass. Case Report: A 70-year post-menopausal woman from Asmara presented with genital swelling which grows gradually over 15 years. She had history of trans-abdominal hysterectomy for abnormal uterine bleeding before 20 years. She had also history of right sided body weakness due to cerebro-vascular accident for the last10 years. She had no known chronic diseases such as hypertension or diabetes mellitus. On physical examination, she is a wheelchair patient with right sided hemiplegia and old midline abdominal scar. On genitourinary examination, patient had a large, about 20x18cm, non-tender, irregular, nodular mass, that hangs from the right side of the labia majora to the level of one third of upper thigh. She had also multiple nodular lesions around the ano-genital area. Different laboratory baseline investigations revealed normal finding. She was operated on 30/10/2022 and a 4kg vulvar mass was resected with right partial hemi-vulvoctomy and sample was sent for pathology which revealed fibromatosis. She was discharged with full improvement and currently on follow-up for possible recurrence. Conclusion: This is reported for its rarity and its enormously large size, slow growing and non-invasive nature. Besides, this was atypical being in a postmenopausal woman, and it’s important to highlight that desmoids tumors should be included in the differential diagnosis of any vulvar mass. She was managed with surgical intervention as it was extremely big. Enhancing community and health professionals’ awareness on similar health problems is crucial for early intervention of similar r conditions.

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