A CASE REPORT OF FIBROTHECOMA

Ovarian fibrothecomas comprise a spectrum of ovarian sex cord stromal tumours where there are components of both an ovarian fibroma and an ovarian thecoma. They account for 3-4 percentage of all ovarian tumours and 90 percentage are unilateral. Ovarian fibrothecomas are uncommon tumours of gonadal stromal cell origin. Mostly it occurs in post menopausal age group with features of metorrhagia. Here, we describe a rare case of a unilateral ovarian fibrothecoma in a perimenopausal woman who presented with a large pelvic mass. A 38 year old (P2L2) woman came with complaints of abdominal distension with loss of weight and appetite with no menstrual disturbances. On examination there was a large pelvic mass of 24 X 24 cm size. CA 125 was mildly elevated and CT abdomen shows adnexal mass with ascites. In view of features of malignant ovarian mass staging laparotomy was planned and preceded to total abdominal hysterectomy and bilateral salphingo-oopherectomy was done. Histopathological examination revealed that it was fibrothecoma surprisingly. Although rare, ovarian fibrothecoma should be considered in patients presenting with a large pelvic mass in perimenopausal age group. Radical surgery is the preferred management strategy for perimenopausal women with ovarian fibrothecomas and is associated with a good prognosis.