A Case Report of Ovarian Fibrothecoma in a Premenopausal Women with Recurrent Menorrhagia


  • Meral Rexhepi Department of Gynecology and Obstetrics, Clinical Hospital, Tetovo, Republic of Macedonia; Faculty of Medical Sciences, University of Tetovo, Republic of Macedonia
  • Elizabeta Trajkovska Department of Pathology, Clinical Hospital, Tetovo, Republic of Macedonia
  • Hysni Ismaili Faculty of Medical Sciences, University of Tetovo, Republic of Macedonia
  • Majlinda Azemi University Clinic of Gynaecology and Obstetrics, University “Ss Cyril and Methodius”, Skopje, Republic of Macedonia




Ovarian granulosa cell tumor, Fibrothecoma, Endometrial hyperplasia


BACKGROUND: Ovarian fibrothecoma is a rare, benign, sex cord-stromal neoplasm, with a typically unilateral location in the ovary, characterized by mixed features of both fibroma and thecoma. Ovarian fibrothecoma is uncommon tumor of gonadal stromal cell origin accounting for 3-4% of all ovarian tumours.

CASE PRESENTATION: We presented a rare case of a 46-year-old patient with recurrent menorrhagia in the past two years with no previous medical, surgical or gynecological history. She underwent two times curettage procedures. At the admission to hospital ultrasonography showed a homogenous solid right ovarian mass of size 2.5 cm x 3.5 cm. Endometrial curettage revealed simple hyperplasia of the endometrium. Diagnostic evaluation and surgical management are discussed along with a brief review of the literature. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was carried out. Histopathology confirmed fibrothecoma of the ovary, proliferative endometrium with hyperplasia without atypia and multiple uterine fibroids.

CONCLUSION: In all patients presenting with recurrent menorrhagia and adnexal tumor the possibility of a granulosa cell tumor must be kept in mind during evaluation.


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Obeidat RA, Aleshawi AJ, Obeidat HA, Al Bashir SM. A rare presentation of ovarian fibrothecoma in a middle age female: Case report. Int J Womens Health. 2019;11:149-52. https://doi. org/10.2147/ijwh.s191549 PMid:30881143

Podfigurna-Stopa A, Czyzyk A, Katulski K, Moszynski R, Sajdak S, Genazzani AR, et al. Recurrent endometrial hyperplasia as a presentation of estrogen-secreting thecoma case report and mini review of the literature. Gynecol Endocrinol. 2016;32(3):184-7. https://doi.org/10.3109/0951359 0.2015.1113519 PMid:26585670

Matalliotaki C, Matalliotakis M, Ieromonachou P, Goulielmos G, Zervou M, Laliotis A, et al. Co existence of benign gynecological tumors with endometriosis in a group of 1,000 women. Oncol Lett. 2018;15(2):1529-32. https://doi.org/10.3892/ol.2017.7449 PMid:29434846

Krishnan D, Kumar K, Thomas A. Unilateral ovarian fibrothecoma with menorrhagia. Malaysian J Pathol. 2014;36(1):55-8. PMid:24763236

Shen Y, Liang Y, Cheng X, Lu W, Xie X, Wan X. Ovarian fibroma/fibrothecoma with elevated serum CA125 level. A cohort of 66 cases. Medicine. 2018;97(34):e11926. https:// doi.org/10.1097/md.0000000000011926 PMid:30142807

Parwate N, Patel S, Arora R, Gupta M. Ovarian fibroma: A clinico-pathological study of 23 cases with review of literature. J Obstet Gynecol India. 2016;66(6):460-5. https://doi.org/10.1007/ s13224-015-0717-6 PMid:27821988

Salemis N, Panagiotopoulos N, Papamichaill V, Kiriakopoulos K, Niakas E. Bilateral ovarian fibrothecoma. An uncommon cause of a large pelvic mass. Int J Surg Case Rep. 2011;2(3):29-31. https://doi.org/10.1016/j.ijscr.2010.07.005 PMid:22096681

Chen H, Liu Y, Li-Fei S, Jiang M, Yang ZF, Fang GP. Ovarian thecoma-fibroma groups: Clinical and sonographic features with pathological comparison J Ovarian Res. 2016;9:81. https://doi. org/10.1186/s13048-016-0291-2

Wu B, Peng J, Gu J, Cheng F, Mao J. MRI diagnosis of ovarian fibrothecomas: Tumour appearances and oestrogenic effect features. Br J Radiol. 2014;87(1038):20130634. https://doi. org/10.1259/bjr.20130634 PMid:24670054

Sharma S, Bansal R, Upreti S, Khare A, Sharma S, Agarwal D. Ovarian fibrothecoma with extensive cystic degeneration: Two case reports. Indian J Clin Pract. 2013;23(1):840-1. PMid:15786755

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(5):473-e1-4. https://doi.org/10.1016/j.ajog.2008.03.053 PMid:18501324.

Vyas N, Manjeera L, Rai S. Delayed menopause at the age of 64 due to ovarian granulosa cell tumor. J Clin Diagn Res. 2013;7(10):2306-7. PMid:24298512

Ayhan A, Slman MC, Velipasaoglu M, Sakinci M, Yuce K. Prognostic factors in adult granulosa cell tumors of the ovary: A retrospective analysis of 80 cases. J Gynecol Oncol. 2009;20(3):158-63. https://doi.org/10.3802/jgo.2009.20.3.158 PMid:19809549

Bacalbasa N, Stoica C, Popa I, Mirea G, Balescu I. Endometrial carcinoma associated with ovarian granulosa cell tumors--a case report. Anticancer Res. 2015;35(10):5547-50. PMid:26408724

Ting Y, Yang L, Juan Z, Xing W, Feng YX. Ovarian thecoma with massive pleural effusion in postmenopausal women: A case report. Mol Clin Oncol. 2016;4(6):1003-5. https://doi. org/10.3892/mco.2016.853 PMid:27284435

Roberts P, Mozes S, Coburn N, Hamilton P, Gien LT. Retroperitoneal extraovarian fibrothecoma mimicking a malignant epithelial ovarian carcinoma. Case Rep Obstet Gynecol. 2012;2012:281745. https://doi.org/10.1155/2012/281745 PMid:22928131

Angeles RM, Salem FL, Sirota RL. A right ovarian mass in a 71-year-old woman with ascites and elevated CA 125 level. Arch Pathol Lab Med. 2005;129(5):701-2. PMid:15859649

Ramkumar S, Jyotsna VP, Mallick S, Kachhawa G, Kriplani A, Ammini AC. Bilateral thecoma presenting as premenopausal hirsutism: Laparoscopic removal. Indian J Endocrinol Metab. 2013;17(3):662-4. https://doi.org/10.4103/2230-8210.123561 PMid:24910832

Sheikh AA, Ganapathy H, Prijatham BO. Fibrothecoma a rare benign ovarian neoplasm. Sch J Med Case Rep. 2017;5(1):65-7.

Numanoglu C, Kuru O, Sakinci M, Akbayir O, Ulker V. Ovarian fibroma/fibrothecoma: Retrospective cohort study shows limited value risk of malignancy index score. Aust N Z J Obstet Gynaecol. 2013;53(3):287-92. https://doi.org/10.1111/ajo.12090 PMid:23611791

Cho YJ, Lee HS, Kim JM, Joo KY, Kim ML. Clinical characteristics and surgical management options for ovarian fibroma/fibrothecoma: A study of 97 cases. Gynecol Obstet Invest. 2013;76(3):182-7. https://doi.org/10.1159/000354555 PMid:24051436

Loue VS, Gbary E, Koui S, Akpa B, Kouassi A. Bilateral ovarian fibrothecoma associated with ascites, bilateral pleural effusion, and marked elevated serum CA-125. Case Rep Obst Gynecol. 2013;2013:189072. https://doi. org/10.1155/2013/189072 PMid:23431489




How to Cite

Rexhepi M, Trajkovska E, Ismaili H, Azemi M. A Case Report of Ovarian Fibrothecoma in a Premenopausal Women with Recurrent Menorrhagia. Open Access Maced J Med Sci [Internet]. 2020 Jul. 20 [cited 2021 Jun. 25];8(C):101-5. Available from: https://oamjms.eu/index.php/mjms/article/view/4176



Case Reports in Gynecology and Obstetrics