Two Cases of Supernumerary OvaryOne with Large Fibroma with Meig's Syndrome and the Other with Endometriosis and Cystic Change

Abstract

Reports of supernumerary ovaries are rare. We describe two such cases, one with fibroma and the other with endometriosis and cystic change. A large fibroma measuring 17.4 x 12.0 x 7.5 cm in size was found in the supernumerary ovary of the omentum in the first case of a 47-year-old married woman with Meig's syndrome. The second case was associated with endometriosis and cystic change, measuring 11 x 5 x 3 cm in size and located in the upper abdominal cavity. It was attached to the uterus of a 28-year-old pregnant woman who had neither fibroma nor Meig's syndrome. Histologically, corpus albicans and a few primordial germ cells were demonstrated, respectively. A fibroma showing a storiform pattern was found in the first case. The second case had endometriosis and a thin-walled cyst with bleeding and necrosis caused by torsion. Immunohistochemically, desmin, alpha-smooth muscle actin, c-kit, CA125, Na+/K+ATPase, overexpression of p53, myc and ras were all negative in the fibroma cells of the first case, and in the endometriosis and cyst wall of the second case. The fibroma cells were positive for vimentin and estrogen receptor, and the proliferating cell nuclear antigen was sporadically demonstrated in their nuclei. The mutation of the p53 gene at exons 5-8 was not detected by sequence analysis. Using RT-PCR, bax, bcl-2 and p16 were not detected either. Clinically, the two cases presented here did not show abnormal hormonal symptoms. They were diagnosed as abdominal tumors or masses. Based on these considerations, one might assume that supernumerary ovaries are probably more frequent than reported at present.

A Fibroma with Cystic Change Developing in an Accessory Ovary - A Brief Case Report -

“…there have been only a few reports of tumors arising in accessory ovaries; examples of these are cystic mature teratomas, 1 serous cystadenomas, 4 mucinous cystadenomas, Brenner tumor, 5 ste roid cell tumor, 6,7 and sclerosing stromal tumor 2 ( Table 1). A case of a large fibroma arising in supernumerary ovary has been reported, 8 to our knowledge, the occurrence of a fibroma in an accessory ovary has not yet been reported. A fibroma is a common ovarian tumor, occurring almost in variably after puberty and histologically characterized by closely packed spindle stromal cells arranged in a "feather stitched" or storiform pattern.…”

Accessory ovary may be a treatment for infertility: Case report and review of current literatures

“…Fei et al 8 reported a case of accessory ovary cyst complicated with torsion, presented with acute lower abdominal pain, nausea and vomiting, simultaneously with low fever and leukocytosis, these symptoms and signs were similar with cyst torsion in the orthotopic ovary. In addition, Kamiyama et al 17 reported torsion of a supernumerary ovarian endometrial cyst in a 28-year-old pregnant woman (40 weeks gestation). The cyst that attached to the pregnant uterus was removed surgically, and postoperative pathology confirmed hemorrhage and necrosis within the cyst wall, which was pathologically consistent with torsion of ovarian endometrial cyst.…”

Ectopic Ovary: One New Location

“…12,13 The literature reports various cases of tumors arising in ectopic ovaries, such as serous cystadenoma, dermoid cyst, Brenner tumor, sclerosing stromal tumor, steroid cell tumor, mucinous cystadenoma, teratoma and fibroma. 6,[14][15][16][17][18][19] Since 1864 there have been less than 50 cases of ectopic ovary reported in the literature and only in two cases the diagnosis was established prior to the operation. 6,14 Despite the strong association with pathological processes, supernumerary and accessory ovarian tissue has been notoriously difficult to diagnose preoperatively.…”