Ovarian fibromatosis

Ovarian fibromatosis (OF) refers to a rare benign phenomenon where there is tumour-like ovarian enlargement due to diffuse ovarian fibrosis.

It may have a predilection towards younger pre-menopausal females (age range around 13-39 years) with a mean age of presentation of 25 years 5.

There can be different presentations such as menstrual irregularity, abdominal pain, and infrequently hirsutism and virilisation 5.

It is characterised by a proliferation of collagen-producing spindle cells surrounding normal ovarian structures. It is sometimes considered to a complication of massive ovarian oedema 5.

The echogenicity of ovarian fibromatosis on ultrasound can be variable; preserved ovarian follicles may be seen along the periphery of the mass.

May show a relatively hyperdense (to myometrium), homogenous, solid and variably enhancing solid ovarian mass.

It is characterised by the presence of ovarian infiltration and enlargement with partial sparing of normal ovarian structures.

Reported signal characteristics include:

  • T1: low signal
  • T2: low signal which can give a "black garland 4" type appearance
  • T1 dynamic contrast imaging 
    • no significant enhancement of the fibrous component in the parenchymal phase
    • may have a minimal enhancement in the fibrous component in the delayed phase

Ovarian fibromatosis is a benign non-neoplastic condition. It is sometimes managed with a salpingo-oophorectomy.

Imaging differential considerations include other solid ovarian masses such as:

It was first described by R.H. Young and R.E. Scully in 1984 2.

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Article information

rID: 13409
System: Gynaecology
Tag: cases
Synonyms or Alternate Spellings:
  • Fibromatosis of the ovaries
  • Ovarian fibromatosis (OF)

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