Two cases of supernumerary ovary: one with large fibroma with Meig's syndrome and the other with endometriosis and cystic change

Accessory ovary may be a treatment for infertility: Case report and review of current literatures

Accessory ovary is a type of ovarian dysplasia, which is often defined as an ovarian tissue placed near and directly connected to the normal ovary or one of ovarian ligaments. It is often asymptomatic, mostly is found or diagnosed at laparotomy, laparoscopy or autopsy. Accessory ovary is often excised during surgery due to its potential malignant behavior. We report a case of endometriosis cyst occurred simultaneously in right side of orthotopic and accessory ovaries, together with torsion 180° of accessory ovarian cyst. Considering that the patient had not given birth and the large size of cysts, exploratory laparotomy was performed. During laparotomy, both site of ovarian cyst have been removed with orthotopic and accessory ovarian tissues preserved. After surgery, a large number of antral follicles were found both in right side of orthotopic and accessory ovaries by ultrasonography. Accessory ovary is considered to have physiological function, and can be preserved as a fertility protection measure for women who have fertility requirements. At present, the definition of ectopic ovary, accessory ovary and supernumerary ovary are very vague and rarely discussed separately. So, we proposed a new way to clarify the concepts of ectopic ovary, accessory ovary and supernumerary ovary. Moreover, we advocated that they should be discussed separately in terms of definition and management measures.

Supernumerary ovary on recto-sigmoid colon with associated endometriosis

A supernumerary ovary is a rare gynecological anomaly, and is usually excised due to its malignant transformation potential. We report a case of a supernumerary ovary and endometriosis situated on the anterior rectosigmoid colon. When laparoscopy was conducted, a firm, 5-cm mass was discovered on the anterior rectosigmoid colon along with normal ovaries. In this case, the discovery of a supernumerary ovary implied the presence of endometriosis. It is unusual for endometriosis and a supernumerary ovary to exist simultaneously.

Cystic Endometrioma with Coexisting Fibroma Originating in a Supernumerary Ovary in the Rectovaginal Pouch

A supernumerary ovary is an exceedingly rare disorder, in which the structure containing ovarian tissue is located at some distance from the normally placed ovary. 16 cases of endometriosis or tumors originating in a supernumerary ovary have been published in the English literature, but no case of coexisting endometriosis and a tumor has been published. We present the case of a 40-year-old female with cystic endometrioma with coexisting fibroma originating in a supernumerary ovary in the rectovaginal pouch. The present case is the first to be reported with coexisting endometriosis and a tumor originating in a supernumerary ovary. Our experience with this case and the results of our previous studies of rectovaginal endometriosis indicated that the possibility of originating in a supernumerary ovary shall be examined in cases of cystic endometrioma in the rectovaginal pouch.

Retroperitoneal extraovarian fibrothecoma mimicking a malignant epithelial ovarian carcinoma

Background. Fibrothecomas are benign sex cord-stromal tumors which rarely originate outside of the ovary. To date, two such cases have been reported in the literature. We report the third case of an extraovarian fibrothecoma and the first presenting similarly to a metastatic epithelial ovarian cancer. Clinical History. We describe a 62-year-old woman with history, physical examination, and imaging suggestive of metastatic ovarian cancer. CA-125 was elevated at 1291 U/mL. Paracenteses were negative for malignant cells and core biopsy showed spindle cell proliferation. A primary debulking surgery for a presumed ovarian cancer was planned. Method and Results. At surgery, 6 liters of ascites were drained. The uterus, ovaries, peritoneum, and omentum were normal. An 18 × 11 × 7 cm retroperitoneal mass was found between the left ureter and the sigmoid mesocolon, wrapped with sigmoid colon. Fallopian tubes and ovaries were normal. The mass was resected en bloc with the sigmoid colon, uterus, ovaries, and omentum. Microscopically, there was spindle cell proliferation typical of fibrothecoma. No ovarian tissue was identified in association with the tumor. Conclusion. This third case of extraovarian fibrothecoma highlights the importance of obtaining histologic evidence of malignancy prior to initiating neoadjuvant chemotherapy for a presumed ovarian cancer.