Malignancy Look Alike: A Rare Case of Ovarian Serous Cystadeno-Fibroma; A Case Report

Introduction: Ovarian serous cystadeno-fibroma is a benign tumour of ovary of anonymous aetiology being a very rare tumour of ovary. This tumour mimics malignant one in its presentation as clinical finding, imaging features (MRI can differentiate it from malignant lesions) as well as gross intra operative findings. Complete surgical resection is treatment of choice with excellent prognosis. Case: A 49-year-old unmarried, postmenopausalfor 13years, presented with abdominallump and vague lower abdominal pain since 1 month. On examination, an abdomino-pelvic mass reaching upto epigastrium, cystic to solid in consistency with smooth surface with mild tendernesson palpation. USG abdomen and pelvis showed large complex right ovarian cyst extending upto epigastric region, left complex ovarian cyst with minimal ascites. She underwent surgical staging with complete removal of tumour. Her post-operative period was uneventful. Histopathology revealed bilateral ovarian serous cystadeno-fibroma. Discussion: Adenofibromas are relatively rare tumourarising from the germinal lining and ovarian stroma. On gross examination and ultrasonography, they appear to be malignant which makes the diagnosis difficult. Differential diagnosis includes benign or malignant ovarian tumours, most likely endometrioma, ovarian epithelial lesion, tubo-ovarian abscess etc.