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Pelvic tumours are a rare cause of pleural effusion. We describe an approach to a case of Meigs syndrome with recurrent unilateral pleural effusion. A woman in her 60s' presented with recurrent right‐sided pleural effusion, leading to cough and shortness of breath. Thoracentesis yielded exudative pleural fluid with cytology negative for malignancy. Pleuroscopy revealed inflamed pleura, and pleural biopsy was consistent with inflammatory changes. The patient's cancer antigen 125 level was elevated at 256 U/mL. Given the high suspicion of malignancy, a computed tomography scan of the chest, abdomen, and pelvis was performed and revealed ascites and a large left ovarian and uterine mass. The patient underwent a total abdominal hysterectomy and bilateral salphingo oophorectomy after experiencing three additional episodes of pleural effusion. Histological examination revealed the left ovarian mass to be a cellular fibroma and the uterine masses to be leiomyomata. Following the operation, there was no recurrence of pleural effusion. [ABSTRACT FROM AUTHOR]

In 2002, heterozygous suppressor of fused variants (SUFU+/−) in the germline were described to have a tumor suppressor role in the development of pediatric medulloblastoma (MB). Other neoplasms associated with pathologic germline SUFU+/− variants have also been described among patients with basal cell nevus syndrome (BCNS; BCNS is also known as Gorlin syndrome, nevoid basal cell carcinoma [BCC] syndrome or Gorlin‐Goltz syndrome; OMIM 109400), an autosomal‐dominant cancer predisposition syndrome. The phenotype of patients with germline SUFU+/− variants is very poorly characterized due to a paucity of large studies with long‐term follow‐up. As such, there is a clinical need to better characterize the spectrum of neoplasms among patients with germline SUFU+/− variants so that clinicians can provide accurate counseling and optimize tumor surveillance strategies. The objective of this study is to perform a scoping review to map the evidence on the rate of medulloblastoma and to describe the spectrum of other neoplasms among patients with germline SUFU+/− variants. A review of all published literature in PubMed (MEDLINE), EMBASE, Cochrane, and Web of Science were searched from the beginning of each respective database until October 9, 2021. Studies of pediatric and adult patients with a confirmed germline SUFU+/− variant who were evaluated for the presence of any neoplasm (benign or malignant) were included. There were 176 patients (N = 30 studies) identified with a confirmed germline SUFU+/− variant who met inclusion criteria. Data were extracted from two cohort studies, two case‐control studies, 18 case series, and eight case reports. The median age at diagnosis of a germline SUFU+/− variant was 4.5 years where 44.4% identified as female and 13.4% of variants were de novo. There were 34 different neoplasms (benign and malignant) documented among patients with confirmed germline SUFU+/− variants, and the most common were medulloblastoma (N = 59 patients), BCC (N = 21 patients), and meningioma (N = 19 patients). The median age at medulloblastoma diagnosis was 1.42 years (range 0.083–3; interquartile range 1.2). When data were available for these three most frequent neoplasms (N = 95 patients), 31 patients (32.6%) had neither MB, BCC nor meningioma; 51 patients (53.7%) had one of medulloblastoma or BCC or meningioma; eight patients (8.4%) had two of medulloblastoma or BCC or meningioma, and five patients (5.3%) had medulloblastoma and BCC and meningioma. This is the first study to synthesize the data on the frequency and spectrum of neoplasms specifically among patients with a confirmed germline SUFU+/− variant. This scoping review is a necessary step forward in optimizing evidence‐based tumor surveillance strategies for medulloblastoma and estimating the risk of other neoplasms that could impact patient outcomes. [ABSTRACT FROM AUTHOR]

Abstract Pelvic tumours are a rare cause of pleural effusion. We describe an approach to a case of Meigs syndrome with recurrent unilateral pleural effusion. A woman in her 60s' presented with recurrent right‐sided pleural effusion, leading to cough and shortness of breath. Thoracentesis yielded exudative pleural fluid with cytology negative for malignancy. Pleuroscopy revealed inflamed pleura, and pleural biopsy was consistent with inflammatory changes. The patient's cancer antigen 125 level was elevated at 256 U/mL. Given the high suspicion of malignancy, a computed tomography scan of the chest, abdomen, and pelvis was performed and revealed ascites and a large left ovarian and uterine mass. The patient underwent a total abdominal hysterectomy and bilateral salphingo oophorectomy after experiencing three additional episodes of pleural effusion. Histological examination revealed the left ovarian mass to be a cellular fibroma and the uterine masses to be leiomyomata. Following the operation, there was no recurrence of pleural effusion.

Abstract Background Nevoid basal cell carcinoma syndrome (NBCCS, Gorlin syndrome) is a rare autosomal dominantly inherited disorder that is characterized by multisystem disorder such as basal cell carcinomas, keratocystic odontogenic tumors and skeletal abnormalities. Bilateral and/or unilateral ovarian fibromas have been reported in individuals diagnosed with NBCCS. Case presentation A 22-year-old female, presented with low back pain, and was found to have bilateral giant adnexal masses on pelvic ultrasonography, which had been suspected to be malignant ovarian tumors. Positron emission tomography/computed tomography showed multiple intracranial calcification and skeletal abnormalities. The left adnexa and right ovarian tumor were resected with laparotomy, and pathology revealed bilateral ovarian fibromas with marked calcification. We recommended the patient to receive genetic testing and dermatological examination. No skin lesion was detected. Germline testing identified pathogenic heterozygous mutation in PTCH1 (Patched1). Conclusions The possibility of NBCCS needs to be considered in patients with ovarian fibromas diagnosed in an early age. Skin lesions are not necessary for the diagnosis of NBCCS. Ovarian fibromas are managed with surgical excision with an attempt at preserving ovarian function. Follow-up regime and counseling on options for future fertility should be offered to patients.

Background: Nevoid basal cell carcinoma syndrome (NBCCS, Gorlin syndrome) is a rare autosomal dominantly inherited disorder that is characterized by multisystem disorder such as basal cell carcinomas, keratocystic odontogenic tumors and skeletal abnormalities. Bilateral and/or unilateral ovarian fibromas have been reported in individuals diagnosed with NBCCS. Case presentation: A 22-year-old female, presented with low back pain, and was found to have bilateral giant adnexal masses on pelvic ultrasonography, which had been suspected to be malignant ovarian tumors. Positron emission tomography/computed tomography showed multiple intracranial calcification and skeletal abnormalities. The left adnexa and right ovarian tumor were resected with laparotomy, and pathology revealed bilateral ovarian fibromas with marked calcification. We recommended the patient to receive genetic testing and dermatological examination. No skin lesion was detected. Germline testing identified pathogenic heterozygous mutation in PTCH1 (Patched1). Conclusions: The possibility of NBCCS needs to be considered in patients with ovarian fibromas diagnosed in an early age. Skin lesions are not necessary for the diagnosis of NBCCS. Ovarian fibromas are managed with surgical excision with an attempt at preserving ovarian function. Follow-up regime and counseling on options for future fertility should be offered to patients. [ABSTRACT FROM AUTHOR]

Ovarian fibroma is a rare ovarian tumor and in pregnancy under the age of 30 years. A 27 years old female primigravida with 9 months of amenorrhea at term was sectioned for non descent of head on full cervical dilitation. A baby of APGAR score 4/10 was born. During cesarean section bilateral ovarian masses were found incidentally. Biopsies were taken from both the masses and it was reported to be bilateral ovarian fibroma with calcification. All the imaging done before and during pregnancy did not report any adnexal lesion. [ABSTRACT FROM AUTHOR]

Abstract Ovarian fibroma is the most common benign pure stromal tumor. It has no specific clinical manifestation, most of which are pelvic or adnexal masses. 10-15% of cases with hydrothorax or ascites, after tumor resection, hydrothorax and ascites disappear, known as Meigs Syndrome. The elevated level of CA125 in a few patients was easily misdiagnosed as ovarian malignant tumor. A case of bilateral Ovarian fibroma associated with Meigs Syndrome is reported and the literature is reviewed in order to improve the understanding of the changes and avoid misdiagnosis.

Small ovarian fibroids (< 10cm) associated with elevated serum CA125 levels are rare, particularly in women of reproductive age. We report a rare case diagnosed in a 35-year-old patient after appendectomy for a solid ovarian mass of approximately 5cm in maximum diameter accompanied by elevated serum CA125 levels. During the preoperative examination, no signs of inflammation from the genital system were found, and no history of endometriosis, uterine leiomyomas, or non-gynecological cancer was reported. Intraoperative rapid biopsy obtained from the ovarian tumor was negative for malignancy. Histological examination of the surgical specimen confirmed the diagnosis of ovarian fibroma. The postoperative course was uneventful without complications. Two months after surgery the serum CA125 levels were within normal limits. The patient is monitored at regular intervals in the gynecology clinic. In the present work, based on the modern literature data, a brief review is attempted mainly regarding the diagnostic and therapeutic approach of this rare nosological entity. [ABSTRACT FROM AUTHOR]

Ovarian fibroma is the most common benign pure stromal tumor. It has no specific clinical manifestation, most of which are pelvic or adnexal masses. 10-15% of cases with hydrothorax or ascites, after tumor resection, hydrothorax and ascites disappear, known as Meigs Syndrome. The elevated level of CA125 in a few patients was easily misdiagnosed as ovarian malignant tumor. A case of bilateral Ovarian fibroma associated with Meigs Syndrome is reported and the literature is reviewed in order to improve the understanding of the changes and avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Intermittent severe abdominal pain is a medical emergency with multiple possible underlying causes. This case report describes a 30-year-old female experiencing severe pelvic pain alternating between the left and right lower abdomen. The pain was periodic and very intense. She also experienced intermittent, vague pain in the upper abdomen. Clinical examination and imaging suggested torsion and detorsion of an ovarian fibroma or dysgerminoma. Additionally, a distended dolichocolon was seen in the upper abdomen. Laparoscopy revealed a twisted and enlarged right ovary in the pelvis. In the upper abdomen, a distended dolichocolon was observed along with a twisted, black spleen. The blood vessels of the wandering spleen hung over the colon like a rubber band, causing constriction. The ovary was removed and diagnosed as a cellular fibroma after histopathological examination. Attempts to untwist the spleen laparoscopically were unsuccessful, so a mini-laparotomy was performed to manually untwist it. Afterward, the spleen regained its normal position and color. Due to the significantly elongated dolichosigmoid, which could cause further complications, the affected segment was removed and a reanastomosis was performed. At the end of the procedure, the spleen remained stable in its original position with a healthy coloration. In retrospect, this patient experienced intermittent twisting of the ovary and spleen over an 18-month period, causing severe abdominal pain. The key lessons from this case are to take abdominal pain seriously, thoroughly examine all areas during surgery, and avoid stopping the investigation after identifying a single issue. A critical approach is essential to pinpointing the cause of each specific symptom, as one pathology may not always explain all observed symptoms. This comprehensive approach ultimately saved the patient's spleen., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dreesen et al.)

Pseudo-Meig’s syndrome is an unusual presentation in which a benign ovarian tumour develops with ascites and pleural effusion. Diagnosis of exclusion is made only after ovarian fibroma has been ruled out and confirmed by disappearance of pleural effusion. The present case report is of a 55-year-old female, who presented with progressive shortness of breath, on and off right chest pain, and abdominal distension, over a period of 2-3 months. Clinical examination and a chest radiograph confirmed pleural effusion as the cause of progressive dyspnea. Presence of a pelvic mass and an elevated serum Cancer Antigen-125 (CA-125) increased the probability of malignancy. After complete tumour resection, a pathological report confirmed a benign ovarian tumour. The authors highlight the importance of suspicion, careful general examination, radiological evaluation, and histologic examination to confirm the diagnosis of pseudo-Meig’s syndrome.

Background: Nearly 90% of all the hormone-producing ovarian tumours are sex cord-stromal tumours (SCSTs). The Ovarian fibroma is a hormonally inactive variant of SCST. It is composed of spindle, oval, round cells producing collagen and accounts for approximately 4% of all ovarian neoplasms. Amongst the other SCSTs, Inhibin B is an important tumour marker. It is a heterodimeric glycoprotein hormone that is secreted primarily by the granulosa cells of the developing follicles. High levels of Inhibin-B can hamper follicular recruitment, leading to amenorrhea in a reproductive age woman. Finding: In this case report, we describe a rare case of a reproductive age female presenting with secondary amenorrhea, having an Ovarian Fibroma, producing massive amounts of Inhibin B. Significance: Although some pathological variants of ovarian fibromas like cyst-adeno-fibroma and ovarian fibro-thecoma are known to secrete inhibin B, benign /pure ovarian fibromas rarely do so. [ABSTRACT FROM AUTHOR]

Abstract Objective Ovarian fibromas and adenofibromas are rare ovarian tumours. They are benign tumours composed of spindle-like stromal cells (pure fibroma) or a mixture of fibroblast and epithelial components (adenofibroma). We have previously shown that 40% of benign serous ovarian tumours are likely primary fibromas due to the neoplastic alterations being restricted to the stromal compartment of these tumours. We further explore this finding by comparing benign serous tumours to pure fibromas. Results Performing copy number aberration (CNA) analysis on the stromal component of 45 benign serous tumours and 8 pure fibromas, we have again shown that trisomy of chromosome 12 is the most common aberration in ovarian fibromas. CNAs were more frequent in the pure fibromas than the benign serous tumours (88% vs 33%), however pure fibromas more frequently harboured more than one CNA event compared with benign serous tumours. As these extra CNA events observed in the pure fibromas were unique to this subset our data indicates a unique tumour evolution. Gene expression analysis on the two cohorts was unable to show gene expression changes that differed based on tumour subtype. Exome analysis did not reveal any recurrently mutated genes.

Pseudo-Meig's syndrome is an unusual presentation in which a benign ovarian tumour develops with ascites and pleural effusion. Diagnosis of exclusion is made only after ovarian fibroma has been ruled out and confirmed by disappearance of pleural effusion. The present case report is of a 55-year-old female, who presented with progressive shortness of breath, on and off right chest pain, and abdominal distension, over a period of 2-3 months. Clinical examination and a chest radiograph confirmed pleural effusion as the cause of progressive dyspnea. Presence of a pelvic mass and an elevated serum Cancer Antigen-125 (CA-125) increased the probability of malignancy. After complete tumour resection, a pathological report confirmed a benign ovarian tumour. The authors highlight the importance of suspicion, careful general examination, radiological evaluation, and histologic examination to confirm the diagnosis of pseudo-Meig's syndrome. [ABSTRACT FROM AUTHOR]

Basal cell nevus syndrome (BCNS) is a rare neurocutaneous syndrome characterized by tumorigeneses such as basal cell carcinomas, jaw cysts, ovarian fibromas, and cardiac fibromas. We present a 24-year-old female with calcified ovarian fibromas associated with BCNS. She had a surgical history of the maxillary cyst and was diagnosed with BCNS due to the cutaneous pits. Magnetic resonance imaging indicated an 8-cm mass and a 4-cm mass, which had been suspected to be a subserosal myoma and a fibroma, respectively. GnRH agonist was preoperatively administered; however, the size of the masses did not change. In laparoscopy, a tumor consisting of 8- and 5-cm masses in the right ovary was identified, and tumorectomy was performed. Because both tumors were extraordinarily rigid and could not be morcellated with scalpels or scissors, we removed them by the Luer Bone Rongeurs with minilaparotomy. The histopathological diagnosis was the ovarian fibromas with marked calcification.

Ovarian fibroma with minor sex cord element (MSCE) is a rare tumor. The increased estrogen production due to the presence of MSCE and/or luteinized thecal cells within fibroma can be a risk factor for endometrial hyperplasia or carcinoma.

Objective: Ovarian fibromas and adenofibromas are rare ovarian tumours. They are benign tumours composed of spindle-like stromal cells (pure fibroma) or a mixture of fibroblast and epithelial components (adenofibroma). We have previously shown that 40% of benign serous ovarian tumours are likely primary fibromas due to the neoplastic alterations being restricted to the stromal compartment of these tumours. We further explore this finding by comparing benign serous tumours to pure fibromas. Results: Performing copy number aberration (CNA) analysis on the stromal component of 45 benign serous tumours and 8 pure fibromas, we have again shown that trisomy of chromosome 12 is the most common aberration in ovarian fibromas. CNAs were more frequent in the pure fibromas than the benign serous tumours (88% vs 33%), however pure fibromas more frequently harboured more than one CNA event compared with benign serous tumours. As these extra CNA events observed in the pure fibromas were unique to this subset our data indicates a unique tumour evolution. Gene expression analysis on the two cohorts was unable to show gene expression changes that differed based on tumour subtype. Exome analysis did not reveal any recurrently mutated genes. [ABSTRACT FROM AUTHOR]

Basal cell nevus syndrome (BCNS) is a rare neurocutaneous syndrome characterized by tumorigeneses such as basal cell carcinomas, jaw cysts, ovarian fibromas, and cardiac fibromas. We present a 24-year-old female with calcified ovarian fibromas associated with BCNS. She had a surgical history of the maxillary cyst and was diagnosed with BCNS due to the cutaneous pits. Magnetic resonance imaging indicated an 8-cm mass and a 4-cm mass, which had been suspected to be a subserosal myoma and a fibroma, respectively. GnRH agonist was preoperatively administered; however, the size of the masses did not change. In laparoscopy, a tumor consisting of 8- and 5-cm masses in the right ovary was identified, and tumorectomy was performed. Because both tumors were extraordinarily rigid and could not be morcellated with scalpels or scissors, we removed them by the Luer Bone Rongeurs with minilaparotomy. The histopathological diagnosis was the ovarian fibromas with marked calcification. [ABSTRACT FROM AUTHOR]

Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests.

Nevoid basal cell carcinoma syndrome (NBCC; Gorlin syndrome), an autosomal dominant disorder linked to 9q22.3-q31, and caused by mutations in PTC, the human homologue of the Drosophila patched gene, comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies and calcification of the falx cerebri. We reviewed the findings on 105 affected individuals examined at the NIH since 1985. The data included 48 males and 57 females ranging in age from 4 months to 87 years. Eighty percent of whites (71/90) and 38% (5/13) of African-Americans had at least one basal cell carcinoma (BCC), with the first tumor occurring at a mean age of 23 (median 20) years and 21 (median 20) years, respectively. Excluding individuals exposed to radiation therapy, the number of BCCs ranged from 1 to > 1,000 (median 8) and 1 to 3 (median 2), respectively, in the 2 groups. Jaw cysts occurred in 78/105 (74%) with the first tumor occurring in 80% by the age of 20 years. The number of total jaw cysts ranged from 1 to 28 (median 3). Palmar pits and plantar pits were seen in 87%. Ovarian fibromas were diagnosed by ultrasound in 9/52 (17%) at a mean age of 30 years. Medulloblastoma occurred in 4 patients at a mean age of 2.3 years. Three patients had cleft lip or palate. Physical findings include "coarse face" in 54%, relative macrocephaly in 50%, hypertelorism in 42%, frontal bossing in 27%, pectus deformity in 13%, and Sprengel deformity in 11%. Important radiological signs included calcification of the falx cerebri in 65%, of the tentorium cerebelli in 20%, bridged sella in 68%, bifid ribs in 26%, hemivertebrae in 15%, fusion of the vertebral bodies in 10%, and flame shaped lucencies of the phalanges, metacarpal, and carpal bones of the hands in 30%. Several traits previously considered components of the syndrome (including short fourth metacarpal, scoliosis, cervical ribs and spina bifida occulta) were not found to be significantly increased in the affected individuals. This study delineates the frequency of the clinical and radiological anomalies in NBCC in a large population of US patients and discusses guidelines for diagnosis and management.

Ovarian fibromas are representative in the group of solid benign tumors of the ovary, accounting for 4% of all ovarian masses. Ovarian fibromas have sex cord/stromal origin and appear particularly in the fourth or fifth decade in menopausal women. The aim of this study is to determine the accurate and reproducible ultrasound elements for the diagnosis of ovarian fibromas, through a comparative analysis between the specialty literature and the experience from the “Filantropia” Clinical Hospital of Obstetrics and Gynecology, Bucharest. Mostly clinical asymptomatic or with a nonspecific appearance, ovarian fibromas require a careful approach and a constant differential diagnosis with gynecological tumors, especially uterine pathology, and pelvic masses. This study describes eight clinical cases of ovarian fibromas, diagnosed in the “Filantropia” Clinical Hospital in 2018. All cases were unilateral ovarian tumors, diagnosed by ultrasonography and histopathologicaly confirmed, after surgical treatment. The surgical treatment is mandatory due to the difficult differential diagnosis and the possibility of a malignant involvement. [ABSTRACT FROM AUTHOR]

The Meigs′ syndrome is a rare syndrome defined as the triad of benign solid ovarian tumors, ascites, and pleural effusion, which resolve spontaneously and permanently after tumor resection. Lung collapse due to a large amount of pleural effusion is a common mechanism of death. It always requires surgical treatment. We report an 84-year-old woman with a large ovarian fibroma associated with Meigs′ syndrome and short of breath. It is difficult to diagnose preoperatively and is usually misdiagnosed as an ovarian malignancy. Considering the patient′s serious clinical condition and assuming that she had Meigs′ syndrome with a large ovarian mass and possible lung collapse due to large amount of pleural effusion, we chose the most appropriate surgical treatment after pathologic examination, then enabled definitive diagnosis of the benign tumor and removed the huge ovarian fibroma. This resulted in a timely symptoms resolution, short hospitalization, and relatively low morbidity in elderly.

This case report is about to the surgical treatment of a patient with twisted ovarian fibroma. Patient at menopausal age with reported history of uterine fibroid came to the emergency department of our hospital with symptoms of acute abdomen. Clinically, it was found the presence of a compact painful pelvic mass, which probably came from the right adnexa. The imaging evaluation reinforced the diagnosis of twisted adnexal mass and total abdominal hysterectomy with bilateral adnexectomy was executed. The histological report of the surgical speciment confirmed the diagnose of ovarian fibroma. After 5 days of hospitalization and smooth postoperative course, the patient was discharged from our clinic. To this paper it is attempted based on updated data a quick literature overview of ovarian fibromas especially with regard to the diagnostical and treatment approach. [ABSTRACT FROM AUTHOR]

Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older perimenopausal and postmenopausal women. Occasionally large fibromas may undergo torsion causing acute abdominal pain. Doppler Ultrasonographyimaging is the choice study. CT and MRI are often needed for further characterization and differentiation from other solid ovarian masses. The choice treatment is surgical removal with intraoperative frozensection. Immunohistochemicalanalysis is recommended to rule out the differential diagnosis. Here we present a case of a postmenopausal woman with a large twisted ovarian fibroma reflecting diagnostic and management difficulties including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the surgical approach.

Purpose: The purpose of this study was to correlate the clinical findings, RMI-4 index and frozen section, in cases of ovarian fibroma with the final histopathology. Methods: This is a retrospective study of clinical and pathological features of 23 patients of ovarian fibroma. The patient's age ranged from 34 to 66 years (mean-49 years). The most common presenting symptom was abdominal pain. On clinical examination, the mean size of ovarian tumor was 9.5 cm, CA-125 levels were found to be raised in 14 patients, and it was associated with ascites in 10 patients. USG showed a well-circumscribed mass (with a mean size of 14 cm), on the left side in 14 cases and on the right side in 9 patients. RMI-4 was calculated in all the patients, and it revealed the possibility of a benign histology in 17 patients. All patients underwent exploratory laparotomy with the removal of ovarian tumor followed by frozen section examination. All but one (22/23) patient had positive correlation among frozen section and final histopathological findings. Result: Ovarian fibroma generally tends to occur in post-menopausal women. All the patients in our study of ovarian fibroma were symptomatic, with the presence of palpable mass in majority of patients. RMI-4 Index correlated very well with benign nature of disease. Frozen section has an invaluable role at surgery; fertility-conserving surgery is the choice in young women. Conclusion: Clinical findings, RMI-4 Index and frozen section, play vital roles before and during surgery in cases of benign ovarian tumors. [ABSTRACT FROM AUTHOR]

Background: Meigs' syndrome is defined as the presence of a benign ovarian tumor with pleural effusion and ascites that resolve after removal of the tumor. The pathogenesis of the production of ascites and pleural effusion in this syndrome remains unknown. Aside from pleural effusion and ascites, pericardial effusion is rarely observed in Meigs' syndrome. Here, we report the first case of Meigs' syndrome with preceding pericardial effusion in advance of pleural effusion.Case Presentation: An 84-year-old Japanese non-smoking woman with a history of lung cancer, treated by surgery, was admitted due to gradual worsening of dyspnea that had occurred over the previous month. She had asymptomatic and unchanging pericardial effusion and a pelvic mass, which had been detected 3 and 11 years previously, respectively. The patient was radiologically followed-up without the need for treatment. Two months before admission, the patient underwent a right upper lobectomy for localized lung adenocarcinoma and intraoperative pericardial fenestration confirmed that the pericardial effusion was not malignant. However, she began to experience dyspnea on exertion leading to admission. A chest, abdomen, and pelvis computed tomography scan confirmed the presence of right-sided pleural and pericardial effusion and ascites with a left ovarian mass. Repeated thoracentesis produced cultures that were negative for any microorganism and no malignant cells were detected in the pleural effusions. Pleural fluid accumulation persisted despite a tube thoracostomy for pleural effusion drainage. With a suspicion of Meigs' syndrome, the patient underwent surgical resection of the ovarian mass and histopathological examination of the resected mass showed ovarian fibroma. Pleural and pericardial effusion as well as ascites resolved after tumor resection, confirming a diagnosis of Meigs' syndrome. This clinical course suggests a strong association between pericardial effusion and ovarian fibroma, as well as pleural and peritoneal fluid.Conclusions: In female patients with unexplained pericardial effusion and an ovarian tumor, clinicians should consider the possibility of Meigs' syndrome. Although a malignant disease should be suspected in all patients with undiagnosed pleural and/or pericardial effusion, Meigs' syndrome is curable by tumor resection and should be differentiated from malignancy. [ABSTRACT FROM AUTHOR]

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Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively evaluate the conventional and functional (diffusion- or perfusion-weighted) magnetic resonance (MR) imaging features of ovarian fibroma, fibrothecoma, and thecoma. Materials and Methods: Histologically proven ovarian fibromas ( n = 19), fibrothecomas ( n = 7), and thecomas ( n = 2) were reviewed (26 patients). The morphologic and signal intensity (SI) characteristics on conventional MR imaging ( n = 28, all cases) were analyzed. The b signal intensity on diffusion-weighted image (DWI) ( n = 22) and the time-to-signal intensity curve on perfusion-weighted image (PWI) ( n = 7) were also analyzed. The presence and shape of the ipsilateral ovarian tissue surrounding the lesions were evaluated on T2-weighted image. Results: Twenty-two cases (79%) were predominantly solid tumor. Majority of the detected lesions exhibited the characteristic homogeneous low SI on T1- (24/28, 86%) and T2- (19/28, 68%) weighted image. Conversely, a number of lesions exhibited high SI (9/28, 32%) on T2-weighted image. Most lesions presented with a detectable ipsilateral ovary on T2-weighted image (24/28, 86%). Tumors larger than 6 cm more likely showed atypical morphology (mixed solid and cystic, cystic), atypical SI (high on T1- and T2-weighted image), and large amount ascites. Larger tumor group (>6 cm) was more likely diagnosed as fibrothecoma or thecoma than fibroma by pathology. On DWI, 16 lesions showed low b signal intensity (16/22, 73%). On PWI, all lesions showed curve type 1 or 2 (7/7, 100%), which tends to characterize benign lesions. All (16/16, 100%) pre-menopausal women had a detectable ipsilateral ovary, and six (60%) out of 10 post-menopausal women had a detectable ipsilateral ovary (p < 0.05). Conclusions: Combining conventional morphologic and signal intensity characteristics with the findings from DWI or PWI might help differentiate ovarian fibroma, fibrothecoma, and thecoma from ovarian malignancy, although further prospective larger scale study using DWI and PWI is needed. [ABSTRACT FROM AUTHOR]

The case report of a 24 years pregnant woman who went to the emergency room of "Mariana GrajalesCoello" Teaching Gyneco-obstetrical Provincial Hospital from Santiago de Cuba is presented, due to a pain in the low part of the stomach, besides nauseas and constipation. The diagnosis of ovarian fibroma was considered which was definitive after surgical treatment and after pathological study. Later the clinical follow-up through outpatient department was maintained; the patient had a favorable clinical course and she preserved her pregnancy until her son was born -- a term healthy newborn 'through eutocic childbirth. [ABSTRACT FROM AUTHOR]

Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older perimenopausal and postmenopausal women. Occasionally large fibromas may undergo torsion causing acute abdominal pain. Doppler Ultrasonographyimaging is the choice study. CT and MRI are often needed for further characterization and differentiation from other solid ovarian masses. The choice treatment is surgical removal with intraoperative frozensection. Immunohistochemicalanalysis is recommended to rule out the differential diagnosis. Here we present a case of a postmenopausal woman with a large twisted ovarian fibroma reflecting diagnostic and management difficulties including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the surgical approach. [ABSTRACT FROM AUTHOR]

Objective: Ovarian fibromas are benign neoplasms that arise from the stromal connective tissue of the ovary and constitute 4% of all ovarian neoplasms. We report a case of a twisted ovarian fibroma with ascites and mild pleural effusion which was removed through the vagina under laparoscopic assistance. Case Report: A 45-year-old female who had suffered from intermittent low back and pelvic pain for a year experienced an exacerbation in pain in the few months before admission. Sonography revealed ascites and a pelvic mass 15 cm in diameter and solid in appearance. After laparoscopic inspection and frozen section study to rule out ovarian malignancy, the tumor was removed vaginally. Conclusions: Ovarian fibroma with Meigs syndrome can be differentiated from ovarian malignancy with the assistance of pelvic sonography, laparoscopy and intraoperative frozen section study of the tumor. Once ovarian malignancy is ruled out, ovarian fibroma can be excised vaginally.

Ovarian fibroma represents the commonest benign tumor of the ovarian stroma. The cellular fibroma is a tumor of uncertain malignant potential that may recur or be associated with peritoneal implants. Usually these are solid tumors, sometimes with small areas of cystic degeneration. The authors present a case of a 70-year-old female patient with an enormous cellular ovarian fibroma located at the region of the right adnexa. The aim of this study consists of the presentation, dissection, and proper management of this rare histologic subtype of ovarian tumor. [ABSTRACT FROM AUTHOR]