A case of malignant fibrothecoma of the ovary

Abstract

Fibrothecomas are mesenchymal tumors deriving from the ovarian stromal and consisting of theca-like elements and fibrous tissue. They are common, but their malignant counterpart is extraordinarily rare. Classical malignant fibrothecomas are said to show four or more mitotic figures per 10 high power fields. Here, we describe a rare case of malignant ovarian fibrothecoma in a perimenopausal woman who presented with a large pelvic mass and menorrhagia. Preoperative diagnosis was advanced ovarian malignancy. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy, together with resection of a length of terminal ileum was done. Patient however died 9th postoperative day from complications related to the extensive surgery. Postoperative histology revealed mitotically active intestinal secondary with primary ovarian tumour containing four mitotic figure per 10 high power fields in keeping with malignant fibrothecoma.