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
Treatment and prognosis
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:
History and etymology
It was first described by R.H. Young and R.E. Scully in 1984 2.
- 1. Bazot M, Salem C, Cortez A et-al. Imaging of ovarian fibromatosis. AJR Am J Roentgenol. 2003;180 (5): 1288-90. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Young RH, Scully RE. Fibromatosis and massive edema of the ovary, possibly related entities: a report of 14 cases of fibromatosis and 11 cases of massive edema. Int. J. Gynecol. Pathol. 1984;3 (2): 153-78. - Pubmed citation
- 3. Fukunishi H, Murata K, Takeuchi S et-al. Ovarian fibromatosis with minor sex cord elements. Arch. Gynecol. Obstet. 1996;258 (4): 207-11. Arch. Gynecol. Obstet. (link) - Pubmed citation
- 4. Takeuchi M, Matsuzaki K, Sano N et-al. Ovarian fibromatosis: magnetic resonance imaging findings with pathologic correlation. J Comput Assist Tomogr. 32 (5): 776-7. doi:10.1097/RCT.0b013e318157689a - Pubmed citation
- 5. Lalwani N, Patel S, Ha KY et-al. Miscellaneous tumour-like lesions of the ovary: cross-sectional imaging review. Br J Radiol. 2012;85 (1013): 477-86. Br J Radiol (full text) - doi:10.1259/bjr/92819127 - Free text at pubmed - Pubmed citation