Laparoscopic ovarian‐sparing surgery for a young woman with an exophytic ovarian fibroma

Abstract

Ovarian fibroma can occur in young women of reproductive age. Despite its benign feature, most surgical removals are done in open surgery with oophorectomy. However, an ovarian-sparing tumor resection can be an option, especially for an exophytic type of fibroma, which accounts for more than half of ovarian fibromas. Here we report a case of exophytic ovarian fibroma in a young woman treated by laparoscopic ovarian-sparing surgery. A 27-year-old woman presented with a pelvic mass. Magnetic resonance imaging revealed an 11 cm × 8 cm solid mass connected to the normal-appearing left ovary by a pedicle-like structure. A clinical diagnosis of an exophytic ovarian fibroma was made, and laparoscopic ovarian-sparing surgery with an intraoperative pathological examination was planned. The tumor was resected by cutting the pedicle, morcellated in a pouch and removed. All procedures were performed laparoscopically and the affected ovary was completely preserved. Having confirmation of its benign characteristics by the intraoperative examination, no further excision was performed. The patient conceived 3 months after the surgery and no recurrence was reported. We propose that gynecologists should consider laparoscopic ovarian-sparing surgery for exophytic ovarian fibroma in women of reproductive age.

Ovarian fibromatosis associated with large pedunculated fibroma in a 30‐year‐old woman: A rare coincidence or variant?

“…Furthermore, although an exophytic growth pattern of ovarian fibroma is common, 10 an extreme exophytic proliferation of ovarian fibroma with stalk-like structure has only been reported in an extremely limited occasion. 12 Therefore, among the reported ovarian fibromatosis cases, the current case is extremely unusual because the pedunculated form of fibroma coexisted with ovarian fibromatosis. Whether a large multilobulated fibroma with a stalk-like structure develops as an exaggerated growth form of the nodular portion of ovarian fibromatosis, as a variant or incidentally coexisted, is unclear.…”

“…Furthermore, although an exophytic growth pattern of ovarian fibroma is common, 10 an extreme exophytic proliferation of ovarian fibroma with stalk‐like structure has only been reported in an extremely limited occasion 12 …”

Surgical Treatment of a Rare Case of Ovarian Fibroma Associated With Elevated CA125 Levels in a Patient of Reproductive Age: A Case Report

“…Treatment of ovarian fibromas is surgery. Despite their benign status, most operations involve open surgical access with resection of the ipsilateral adnexa [ 22 ]. Resection of the fibroma with laparotomy or laparoscopy seems to be the appropriate treatment choice in women who wish to preserve fertility.…”

“…The varying degrees of technical difficulties during the attempt to exclude the ovarian tumor, which concern almost all cases, and the challenging accurate preoperative diagnosis of ovarian fibromas do not allow safe laparoscopic resection of ovarian fibromas without peritoneal spread [ 24 ]. Laparoscopic access of ovarian fibromas should be severely considered in cases of exophytic ovarian tumors in women of reproductive age [ 22 ].…”

Laparoscopic Surgery for Bilateral Multiple Calcified Ovarian Fibromas: A Case Report

“…Indeed, it was observed that in many case reports in the literature, premenarchal patients underwent radical procedures such as oophorectomy for benign fibromas [9,10]. Besides, a small number of cases reported with ovarian sparing surgery were applied with laparoscopic approach for fibromas [11].…”