Ovarian fibrothecoma in an adolescent presenting as ovarian torsion: A case report

Ovarian fibrothecomas are rare benign stromal tumors, very rare in the pediatric population. A 16-year-old adolescent with no prior medical history presented to the emergency room with acute pelvic pain and vomiting. Clinical examination revealed left iliac fossa tenderness and an adnexal mass. Pelvic ultrasound showed a well-defined, 110 mm × 80 mm, hyperechoic left ovarian mass with absent vascularization on Doppler imaging. All bood tests, including CA-125, were normal. Due to the suspicion of ovarian torsion, an emergency laparotomy was performed, confirming a 720-degree left ovarian torsion. The mass was completely resected preserving a portion of the left ovary. Histopathological analysis was consistent with a fibrothecoma. The postoperative recovery was uneventful. Follow-up ultrasounds at 1 and 6 months after the operation showed no recurrence of the tumor. Ovarian fibrothecomas, although rare, should be included in the differential diagnosis of solid ovarian masses in adolescents. • Ovarian fibrothecoma is a rare benign tumor. • It most commonly reveals by pelvic pain and abdominal distention. • Very rare tumor in adolescents. • Diagnosis relies on imaging techniques such as ultrasound and MRI. • The treatment is surgical and the prognosis for these tumors is generally favorable.