Aims: The aims of this study were to analyze the clinical characteristics, diagnostic features, and operative outcomes of patients with ovarian fibroma/fibrothecoma and to discuss appropriate management options. Methods: We performed a retrospective comparative analysis of 97 patients with ovarian fibroma/fibrothecoma who underwent laparoscopic and laparotomic procedures, including tumorectomy between January 2008 and December 2011. Results: The mean patient age was 42.5 ± 11.4 years. Seventy-three patients (75.3%) were premenopausal women. A preoperative diagnosis of benign ovarian tumor or fibroma was made in only 49 cases (50.5%). We found that 42.2% of cases were misdiagnosed as uterine myomas (n = 41) and 6.2% were misdiagnosed as malignant ovarian tumors (n = 6). The presence of ascites was associated with larger tumor size (p < 0.05) but not higher CA125 levels (p = 0.159). Twenty-nine patients (29.9%) underwent laparotomy, and 68 (70.1%), laparoscopic surgery. Laparoscopic surgery facilitated shorter operation times than laparotomy (p < 0.05). Tumorectomy was performed in 40 patients (43.5%), 36 (90%) of whom underwent laparoscopy with operative outcomes comparable to those of patients who underwent laparotomy. Conclusions: Ovarian fibromas/fibrothecomas are often misdiagnosed as uterine myomas and malignant ovarian tumors. Laparoscopic surgery including tumorectomy may be an effective surgical approach in patients with ovarian fibromas/fibrothecomas.

1.
Philippe E, Charpin C: Pathologie gynécologique et obstétricale. Paris, Masson, 1992, pp 196-197.
2.
Sfar E, Ben Ammar K, Mahjoub S, Zine S, Kchir N, Chelli H, Khrouf M, Chelli M: Anatomo-clinical characteristics of ovarian fibrothecal tumors. 19 cases over 12 years: 1981-1992. Rev Fr Gynecol Obstet 1994;89:315-321.
3.
Gargano G, De Lena M, Zito F, Fanizza G, Mattioli V, Schittulli F: Ovarian fibroma: our experience of 34 cases. Eur J Gynaecol Oncol 2003;24:429-432.
4.
Sivanesaratnam V, Dutta R, Jayalakshmi P: Ovarian fibroma-clinical and histopathological characteristics. Int J Gynaecol Obstet 1990;33:243-247.
5.
Chechia A, Attia L, Temime RB, Makhlouf T, Koubaa A: Incidence, clinical analysis, and management of ovarian fibromas and fibrothecomas. Am J Obstet Gynecol 2008;199:473.e1-e4.
6.
Patsner B: Meigs syndrome and ‘false positive' preoperative serum CA-125 levels: analysis of ten cases. Eur J Gynaecol Oncol 2000;21:362-363.
7.
Seracchioli R, Bagnoli A, Colombo FM, Missiroli S, Venturoli S: Conservative treatment of recurrent ovarian fibromas in a young patient affected by Gorlin syndrome. Hum Reprod 2001;16:1261-1263.
8.
Christman JE, Ballon SC: Ovarian fibrosarcoma associated with Maffucci's syndrome. Gynecol Oncol 1990;37:290-291.
9.
Chen CP, Yang YC, Lin SP, Wang W, Chang CL, Chang KM: Bilateral calcified ovarian fibromas in a patient with Sotos syndrome. Fertil Steril 2002;77:1285-1287.
10.
Son CE, Choi JS, Lee JH, Jeon SW, Hong JH, Bae JW: Laparoscopic surgical management and clinical characteristics of ovarian fibromas. JSLS 2011;15:16-20.
11.
Târcoveanu E, Dimofte G, Niculescu D, Vasilescu A, Moldovanu R, Ferariu D, Marcovici I: Ovarian fibroma in the era of laparoscopic surgery: a general surgeon's experience. Acta Chir Belg 2007;107:664-669.
12.
Tinelli A, Pellegrino M, Malvasi A, Lorusso V: Laparoscopical management ovarian early sex cord-stromal tumors in postmenopausal women: a proposal method. Arch Gynecol Obstet 2011;283(suppl 1):87-91.
13.
Leung SW, Yuen PM: Ovarian fibroma: a review on the clinical characteristics, diagnostic difficulties, and management options of 23 cases. Gynecol Obstet Invest 2006;62:1-6.
14.
Young RH, Scully SE: Sex cord-stromal, steroid cell, and other ovarian tumors; in Kurman RJ (ed): Blaustien's Pathology of the Female Genital Tract. New York, Springer, 1987, pp 607-658.
15.
Irving JA, Alkushi A, Young RH, Clement PB: Cellular fibromas of the ovary: a study of 75 cases including 40 mitotically active tumors emphasizing their distinction from fibrosarcoma. Am J Surg Pathol 2006;30:929-938.
16.
Paladini D, Testa A, Van Holsbeke C, Mancari R, Timmerman D, Valentin L: Imaging in gynecological disease (5): clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol 2009;34:188-195.
17.
Valentin L: Gray scale sonography, subjective evaluation of the color Doppler image and measurement of blood flow velocity for distinguishing benign and malignant tumors of suspected adnexal origin. Eur J Obstet Gynecol Reprod Biol 1997;72:63-72.
18.
Bazot M, Ghossain MA, Buy JN, Deligne L, Hugol D, Truc JB, Poitout P, Vadrot D: Fibrothecomas of the ovary: CT and US findings. J Comput Assist Tomogr 1993;17:754-759.
19.
Jung SE, Rha SE, Lee JM, Park SY, Oh SN, Cho KS, Lee EJ, Byun JY, Hahn ST: CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol 2005;185:207-215.
20.
Oh SN, Rha SE, Byun JY, Lee YJ, Jung SE, Jung CK, Kim MR: MRI features of ovarian fibromas: emphasis on their relationship to the ovary. Clin Radiol 2008;63:529-535.
21.
Troiano RN, Lazzarini KM, Scoutt LM, Lange RC, Flynn SD, McCarthy S: Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology 1997;204:795-798.
22.
Outwater EK, Siegelman ES, Talerman A, Dunton C: Ovarian fibromas and cystadenofibromas: MRI features of the fibrous component. J Magn Reson Imaging 1997;7:465-471.
23.
Kitajima K, Kaji Y, Sugimura K: Usual and unusual MRI findings of ovarian fibroma: correlation with pathologic findings. Magn Reson Med Sci 2008;7:43-48.
24.
Topalak O, Saygili U, Soyturk M, Karaca N, Batur Y, Uslu T, Erten O: Serum, pleural effusion, and ascites CA-125 levels in ovarian cancer and nonovarian benign and malignant diseases: a comparative study. Gynecol Oncol 2002;85:108-113.
25.
Timmerman D, Moerman P, Vergote I: Meigs' syndrome with elevated serum CA 125 levels: two case reports and review of the literature. Gynecol Oncol 1995;59:405-408.
26.
Prat J, Scully RE: Cellular fibromas and fibrosarcomas of the ovary: a comparative clinicopathologic analysis of seventeen cases. Cancer 1981;47:2663-2670.
27.
Azoury RS, Woodruff JD: Primary ovarian sarcomas. Report of 43 cases form the Emil Novak Ovarian Tumor Registry. Obstet Gynecol 1971;37:920-941.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.