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J Pediatr Adolesc Gynecol. 2012 Oct;25(5):e107-9. doi: 10.1016/j.jpag.2012.05.012.

Mitotically active cellular ovarian fibroma with Meigs' syndrome and elevated CA-125: towards fertility preservation.

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1
Department of Obstetrics and Gynecology, São João Hospital, Porto, Portugal. sofiambessa@sapo.pt

Abstract

BACKGROUND:

Meigs syndrome is rare in women under 30 years of age and even more if associated with an elevated CA-125. In this case, malignancy was suspected and raised concerns about fertility preservation.

CASE:

A 13-year-old girl presented with a 4-month amenorrhea, abdominal enlargement and dyspnea. Ultrasonography showed a 14-cm solid mass with ascites, bilateral pleural effusion and, analytically, elevated serum CA-125. Unilateral salpingo-oophorectomy was performed, with a 19 × 15 × 12 cm mass being disclosed from the right ovary. Final pathology diagnosed a mitotically active cellular ovarian fibroma (MACF), with no significant nuclear atypia.

CONCLUSION:

MACF is a recent histopathologic entity. Despite the high count of mitotic figures, it is not associated with atypia, which contributes to favorable outcome. Although initial suspicions of malignancy, a conservative surgical intervention allowed fertility preservation. This was clinically appropriate and with no implications on survival and prognosis of these patients.

PMID:
22980413
DOI:
10.1016/j.jpag.2012.05.012
[Indexed for MEDLINE]
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