Diagnostic Dilemma During Laparoscopic Cystectomy of Twisted Serous Cystadenofibroma of Ovary in Adolescent Girl – A Case Report with Literature Review

Suresh Kayastha,Jamuna Kiran Paudel,Rajiv Deo,Hari Om Joshi,Sweta Thapa

doi:10.3126/medphoenix.v6i2.37176

Suresh Kayastha, Jamuna Kiran Paudel + Show 3 more

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https://doi.org/10.3126/medphoenix.v6i2.37176

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Abstract

The most ovarian tumor arises from the surface epithelium and the serous tumor is the most common histological variant. Serous cystadenofibroma is a rare variant of serous tumor that comprises both epithelial and fibrous stromal components. They are benign in nature but may often be misinterpreted as malignant nature due to their solid cystic nature with papillary projections. We herein report a case of twisted right ovarian cyst in 17 years unmarried girl that was clinically and radiologically benign and hence managed laparoscopically. Intraoperatively cyst ruptured that released clear serous fluid. During cystectomy, multiple small to large size (maximum 2x2 cm) papillary projections were noted within the uninoculated cyst without any other solid components. With the possibility of a borderline tumor, the patient party was counseled and opted for cystectomy with the possible need for a second surgery. The final histopathology report was benign serous cystadenofibroma.

Highlights

Serous tumor is the most common epithelial ovarian tumor
Serous cystadenofibroma is a rare variant of serous tumor that comprises of both epithelial and fibrous stromal components
We report a case of a 17 years patient who underwent emergency laparoscopic cystectomy for twisted ovarian cyst and solid cystic nature of the cyst was detected intra-operatively only

Summary

INTRODUCTION

Serous tumor is the most common epithelial ovarian tumor. Cystic adenofibroma is a variant of serous tumor with prominent fibroblastic stromal component.[1]. Because of its solid cystic nature, it may mimic malignant ovarian tumor clinically and radiologically. We report a case of a 17 years patient who underwent emergency laparoscopic cystectomy for twisted ovarian cyst and solid cystic nature of the cyst was detected intra-operatively only. The pain was continuous in nature, and not relieved with intake of oral analgesic at home She gave no history of fever, abdominal distension and was passing flatus. Left ovary was normal .Clinical and radiological diagnosis of twisted right ovary with benign cyst was made (Fig. 1). Right ovarian cyst was noted of size 8x6cm, globular in nature, smooth surface, intact capsule, regular margin without surface nodularities suggestive of benign nature (Fig.[2]).

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CONCLUSION