Massive ovarian edema masquerading as fibroma: A rare case report

Abstract

Massive edema of the ovary is a rare benign entity affecting young women. Most cases are thought to result from venous and lymphatic obstruction. The ultrasonographic appearance is nonspecific and can mimic neoplasia, and the definitive diagnosis requires histological examination. Massive ovarian edema should be suspected in women in reproductive age group presenting with solid enlargement of the ovary. Awareness of this rare entity among surgeons and pathologists is essential in the diagnosis and to avoid unnecessary oophorectomy. We describe one such rare case of massive ovarian edema in a 22-year-old female.

Bilateral ovarian edema with unilateral ovarian leiomyoma and double inferior vena cava: a case report

“…Any ovarian neoplasm that may exhibit edematous or myxoid appearance on the cut section can come in the differential diagnosis of ovarian edema, like fibroma, sclerosing stromal tumor, Krukenberg tumor, luteinized thecoma associated with sclerosing peritonitis, and ovarian myxoma. The presence of preserved follicular structures within an edematous stroma can help differentiate the lesion from fibroma and luteinized thecoma [13].…”

Acute abdomen with a misleading clinical entity

“…[3][4][5][6] MOE was defined as an accumulation of edema fluid within the ovarian stroma separating normal follicular structures forming as a primary or secondary edema. [2][3][4][5][6] MOE divides into primary MOE, which occurs in a normal ovary constituting approximately 85% of MOE cases, and secondary MOE, which occurs when there is an ovarian mass or cyst or due to drugs used for ovulation induction. 3,4 MOE mostly affects young postmenarchal female in their reproductive age with an average age of 20 years and can involve unilateral or bilateral ovaries.…”

“…Ovarian neoplasm that exhibits edematous or myxoid appearance comes in close differential diagnosis includes fibroma, ovarian fibromatosis, ovarian myxoma and sclerosing stromal tumor. 1,6 Fibroma occurs commonly in patients with age more than 30 years. 1,6 These are hormonally inactive and present with abdominal mass and ascites.…”

“…1,6 Fibroma occurs commonly in patients with age more than 30 years. 1,6 These are hormonally inactive and present with abdominal mass and ascites. 1 Cut surface is firm, solid, flat, gray white with whorled appearance.…”

“…6 The affected ovary is soft, fluctuant with oozing of thin edema fluid on cutting. 4,6 Microscopic features are presence of edema fluid, widely separating the ovarian stromal cells, presence of atretic follicles and compressed cortical stroma at the periphery. 2,4,6 The focus of luteinized cells is seen in approximately 40% cases.…”