Ovarian fibromatosis refers to a rare benign phenomenon where there is tumor-like ovarian enlargement due to diffuse ovarian fibrosis.
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Epidemiology
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.
Associations
Clinical presentation
There can be different presentations such as menstrual irregularity, abdominal pain, and infrequently hirsutism and virilisation 5.
Pathology
It is characterized by a proliferation of collagen-producing spindle cells surrounding normal ovarian structures. It is sometimes considered a complication of massive ovarian edema 5.
Radiographic features
Ultrasound
The echogenicity of ovarian fibromatosis on ultrasound can be variable; preserved ovarian follicles may be seen along the periphery of the mass.
CT
May show a relatively hyperdense (to myometrium), homogeneous, solid and variably enhancing solid ovarian mass.
MRI
It is characterized by the presence of ovarian infiltration and enlargement with partial sparing of normal ovarian structures.
T1: hypointense
T2: thick hypointense rim, known as the "black garland sign" 4
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T1 C+ (Gd)
parenchymal phase: no significant enhancement of the fibrous component
delayed phase: the fibrous component may minimally enhance
Treatment and prognosis
Ovarian fibromatosis is a benign, non-neoplastic condition. It is sometimes managed with a salpingo-oophorectomy.
History and etymology
It was first described by R H Young and R E Scully in 1984 2.
Differential diagnosis
Imaging differential considerations include other solid ovarian masses such as: