Diagnostic Dilemma: Parasitic Ovarian Fibroma With Degeneration

An ovarian fibroma is a rare entity and a diagnostic dilemma due to its solid nature and ultrasound findings being similar to a uterine fibroid. An ovarian fibroma, being parasitic, is extremely rare. We report the case of a 35-year-old, multiparous woman who presented with a 'wandering' abdominal mass of six months duration. Clinical examination revealed a 16-week size, solid, firm, well-defined mass in the right lumbar and iliac regions, separate from the uterus on bimanual examination, suggestive of a pedunculated subserous fibroid uterus. Ultrasound abdomen with color Doppler evaluation was suggestive of the non-uterine origin of the tumor, probably a gastrointestinal stromal tumor. In view of the diagnostic dilemma, MRI was done, which showed that the lesion had features characteristic of ovarian fibroma, however, bilateral ovaries were normally visualized. An exploratory laparotomy was performed. There was a solid parasitic tumor adherent to the bladder peritoneum and attached to the right ovary by a thin band, which was excised. Histopathology confirmed ovarian fibroma. To conclude, a parasitic ovarian fibroma is rare and a careful clinical approach with imaging and surgery helps in solving this diagnostic dilemma.