Rapidly Growing Ovarian Fibroma: A
Benign Tumour with Malignant Mimicry

 

Introduction

Ovarian
fibromas are rare benign sex cord stromal tumours accounting for 4 of ovarian
neoplasms 1 They usually affect perimenopausal and postmenopausal women and are often
asymptomatic, found incidentally on imaging or during surgery 1 2
While
typically slow growing and solid, some present atypically with rapid enlargement,
ascites, elevated CA 125 or features mimicking malignancy posing significant diagnostic
challenges 2 3 Rarely they are associated with Meigs syndrome ( pleural effusion, and
ovarian tumour 3 4
This
case reports a postmenopausal woman with a rapidly enlarging ovarian fibroma and acute
symptoms despite initial suspicion of malignancy, histopathology confirmed a benign lesion,
emphasising the need for careful evaluation of adnexal masses even when atypical

 

Discussion

This
case illustrates how benign ovarian fibromas can mimic malignancy, especially when they
show rapid growth, necrosis, or adhesions 1 3 Claustrophobia limited MRI, requiring reliance
on ultrasound and CT, showing the importance of adaptable diagnostic strategies 2
Intraoperatively, the presence of adhesions and peritoneal inflammation necessitated a
multidisciplinary surgical approach 1 Histopathology ultimately confirmed a benign fibroma
with haemorrhagic infarction from torsion reminding clinicians that necrosis and inflammation
are not always malignant 4 This reinforces the importance of maintaining a broad differential,
tailoring management to individual cases, and planning conservatively yet proactively to ensure
patient safety