Massive edema of ovary masquerading as neoplasm in a preteen girl

Massive ovarian oedema, though rare, frequently mimics an ovarian neoplasm, both clinically and radiologically. Here, we discuss the case of a 12-year-old girl who presented with intermittent pain in the lower abdomen for last one month associated with vomiting. A suspicion of germ cell neoplasm was raised on ultrasound despite mildly raised serum markers. Microscopy from left salpingo-ophrectomy specimen revealed marked oedema of ovarian stroma with preserved primordial follicles at the periphery only. This case highlights the importance of a high index of suspicion, clinically, radiologically and pathologically, especially in cases with only mildly raised serum markers to avoid unwarranted surgery and preserve hormonal function as well as fertility in some cases.