Giant primary ovarian fibrosarcoma: Case report and review of pitfalls

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Primary ovarian fibrosarcomas are very uncommon neoplasms; less than one hundred cases have been reported. Diagnosis can be difficult to establish and other similar appearing mesenchymal lesions must be ruled out. A 23 year old nulliparous woman presented with a huge right ovarian tumor (25 × 17 × 12 cm). Ultrasonography guided aspiration was performed and a strong possibility of fibrosarcoma was suggested based on cytomorphological findings. No epithelial element was noted. She underwent surgical excision which confirmed the diagnosis of primary ovarian fibrosarcoma (the largest till date to our knowledge). Immunohistochemical analyses showed vimentin and CD 34 positivity. We speculate that ovarian fibrosarcoma at the preoperative examination might be considered in the differential diagnosis whenever a unilateral, heterogeneous, largely round solid ovarian lesion is detected.