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Case Reports in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 281745, 5 pages
http://dx.doi.org/10.1155/2012/281745
Case Report

Retroperitoneal Extraovarian Fibrothecoma Mimicking a Malignant Epithelial Ovarian Carcinoma

1Division of Surgical Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada M4N 3M5
2Division of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada M5G 2M9
3Department of Anatomical Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada M4N 3M5
4Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON, Canada M4N 3M5
5Department of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
6Division of Surgical Oncology, Sunnybrook Health Sciences Centre and Odette Cancer Centre, Toronto, ON, Canada M4N 3M5
7Division of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada M4N 3M5
8Division of Gynecologic Oncology, Sunnybrook Health Sciences Centre and Odette Cancer Centre, T2-104, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5

Received 30 March 2012; Accepted 10 July 2012

Academic Editors: I. Hoesli, S.-Y. Ku, E. C. Nwosu, and S. Rasmussen

Copyright © 2012 Patrick Roberts et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Fibrothecomas are benign sex cord-stromal tumors which rarely originate outside of the ovary. To date, two such cases have been reported in the literature. We report the third case of an extraovarian fibrothecoma and the first presenting similarly to a metastatic epithelial ovarian cancer. Clinical History. We describe a 62-year-old woman with history, physical examination, and imaging suggestive of metastatic ovarian cancer. CA-125 was elevated at 1291 U/mL. Paracenteses were negative for malignant cells and core biopsy showed spindle cell proliferation. A primary debulking surgery for a presumed ovarian cancer was planned. Method and Results. At surgery, 6 liters of ascites were drained. The uterus, ovaries, peritoneum, and omentum were normal. An 18×11×7 cm retroperitoneal mass was found between the left ureter and the sigmoid mesocolon, wrapped with sigmoid colon. Fallopian tubes and ovaries were normal. The mass was resected en bloc with the sigmoid colon, uterus, ovaries, and omentum. Microscopically, there was spindle cell proliferation typical of fibrothecoma. No ovarian tissue was identified in association with the tumor. Conclusion. This third case of extraovarian fibrothecoma highlights the importance of obtaining histologic evidence of malignancy prior to initiating neoadjuvant chemotherapy for a presumed ovarian cancer.