A case report of bilateral benign Ovarian Fibrothecoma coincidental with ascites: an unconventional co-occurrence

Abstract

Introduction and importance: Ovarian fibrothecoma are a mostly benign and profoundly rare type of gonadal stromal cell tumor. It makes up 3–4% of all kinds of ovarian neoplasia. They are predominantly unilateral in origin and mostly present in women during the postmenopausal phase. Our case is especially important because the tumors occurred bilaterally and were associated with ascites. This seldom happens in patients with ovarian fibrothecoma. Early identification and treatment are key components to avoid the subsequent complications of this tumor. Case presentation: We present the case of a 54-year-old female who presented complaining only of a slow progressive increase in the abdominal contour associated with vague abdominal pain. Our preoperative radiological imaging revealed multiple ovarian and uterine masses. Clinical discussion: Surgical intervention in the form of a hysterectomy with bilateral salpingo-oophorectomy was achieved. Histopathological analysis revealed bilateral benign ovarian fibrothecoma with benign uterine leiomyomas. The patient underwent an uneventful postoperative recovery. Conclusion: Ovarian Fibrothecoma is a rare gynecological pathology. The uniqueness of our case stems from the rarity of its bilateral occurrence and in rare occasions, their occurrence is accompanied by ascites. This kind of co-occurrence should be differentiated from other rare presentations, such as Meigs Syndrome. Therefore, documentation is necessary to circumvent misdiagnoses and to abate the resulting patient morbidity. To further highlight the value of our case, it is to the best of our knowledge, the first documented case of this pathology from our country.

Fibrothecoma a rare ovarian tumor: A case report

“…Unilateral presentation occurs in 90 % of thecomas, while bilateral forms are often associated with Gorlin Goltz syndrome [ 4 ].…”

“…In addition, the co-presence of ascites, hydrothorax, and high CA-125 levels lead to the misdiagnosis of ovarian fibrothecoma as another type of malignant ovarian tumor [ 4 , 7 ].…”