Abstract:

Ovarian fibroma is a common benign sex cord stromal tumor, accompanied by pleural effusion and ascites, which regress to Meigs syndrome after resection. The incidence of Meigs syndrome is relatively low, and the ovarian fibroma with the elevated carbohydrate antigen 125 (CA125) is easily misdiagnosed as malignant tumor. We report a case of 18-year-old female patient with ovarian fibroma who was admitted to an external hospital due to abdominal distension and lower abdominal distension. Imaging showed a huge cystic solid mass in the pelvic cavity (11.3 cm × 10.6 cm × 7.9 cm), a large amount of pelvic and abdominal fluid accumulation, and a significant increase in serum CA125 (1 168.00 U/mL). The patient underwent adnexectomy on the affected side at the First Hospital of Lanzhou University. Multiple adhesive lesions were observed during the surgery, and the postoperative pathological diagnosis was ovarian fibroma. After tumor resection, the patient experienced chest tightness and shortness of breath, and CT showed bilateral pleural effusion. One month after surgery, the pleural and ascites completely subsided, and the level of CA125 returned to normal. Follow up for 2 year after surgery, the patient showed no recurrence or metastasis. Therefore, in clinical practice, pelvic masses with the elevated CA125 and Meigs syndrome may be misdiagnosed as ovarian cancer. This case emphasizes the possibility of ovarian fibroids/follicular membrane fibroids in the differential diagnosis of ovarian tumors with elevated CA125. Surgical resection is the preferred treatment method, and the postoperative prognosis is good.

Key words: Ovarian neoplasms, Fibroma, Diagnosis, Therapy, Case reports