Hemorrhagic infarction of fibroma. MR imaging appearance

Pelvic tumors with normal-appearing shapes of ovaries and uterus presenting as an emergency (Review)

Abdominal pain with an associated pelvic mass is a common problem in everyday practice. Concerns about ectopic pregnancy, torsion of an enlarged ovary or malignancy usually dominate the diagnostic evaluation. On physical and imaging examination, when a palpable painful mass is present in the pelvis and the two ovaries and uterus are detected in their normal anatomical locations, the content and origin of the lesions may be significant in narrowing the pre-operative differential diagnosis. Thus, the emergent pelvic indications discussed in this review should be considered. The causes of acute abdominal pain are few in number and therefore an accurate diagnosis may be most frequently made at the time of exploratory laparotomy.

Ovarian fibroma with marked ascites and elevated serum levels of CA-125 in a young girl

We report a case of ovarian fibroma with marked ascites and elevated serum CA-125 levels in a young girl. Ovarian fibromas are rare in children. They usually present as a solid mass and may be associated with ascites and elevated serum CA-125 levels. Because of their solid nature and these associations, they can be mistaken for a malignant tumor, resulting in unnecessary oophorectomy. Ovarian fibromas are benign neoplasms, and the prognosis is extremely good. Surgical management should be an ovarian-sparing tumor excision. Although uncommon in pediatric patients, ovarian fibromas should be included in the differential diagnosis of ovarian mass in children.

Usual and unusual MRI findings of ovarian fibroma: correlation with pathologic findings

Ovarian fibromas typically exhibit low signal intensity on T(2)-weighted images, which reflects their abundant fibrocollagenous stroma. However, the mass of larger tumors often demonstrates high signal intensity on T(2)-weighted images, which reflects varied degenerative changes, such as cystic degeneration, edematous change, hemorrhagic infarction, or necrosis caused by torsion and myxomatous change. We illustrate typical and atypical magnetic resonance (MR) imaging findings of ovarian fibromas and correlate them with histopathologic findings.