Ovarian fibroma

Case contributed by Dr Hala Maher

Presentation

Progressive lower abdominal swelling with newly developed pain.

Patient Data

Age: 55 years
Gender: Female
Ultrasound

Transabdominal pelvic ultrasound shows a well-defined, large, anteriorly located
solid mass with related pedicle noted (diameter about 6 mm). The mass shows central cystic degenerative changes with faint internal vascularity on color Doppler.


The uterus itself is compressed and displaced posteriorly.
Mild free fluid in cul de sac is also noted.

Pathology

Intraoperative image shows a well-capsulated lobulated solid mass lesion originating from the left ovary ,with a dilated and congested ipsilateral fallopian tube.

Case Discussion

This case was provisionally diagnosed by ultrasound as a pedunculated subserous myoma originating from the uterine wall as the classic criteria of fibroid lesion were noted. It is very common on ultrasound to confuse a pedunculated myoma and an ovarian fibroma, and the described pedicle proved to be the dilated fallopian tube.

The patient was admitted for myomectomy due to pain with suspected twisted pedicle and ended by left salpingo-oopherectomy.

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