Clinical Case Reports

Management of a Borderline Brenner Tumor of the Ovary in a Premenopausal Woman in Northern Tanzania. A Rare Case Report and Review of the Current Literature

ABSTRACTBrenner tumors are rare ovarian neoplasms that are typically small and unilateral. Most cases are benign; less than 5% of all Brenner tumors are borderline or proliferative. Brenner tumors originate from the follicular epithelium and consist of ovarian transitional cells surrounded by fibrous tissue. Here we present a case of a 49‐year‐old premenopausal woman from Northern Tanzania. This patient presented to our facility with acute abdominal pain. She also reported abdominal distention which was first noticed 12 months prior to presentation. Magnetic resonance imaging (MRI) identified a 21 × 17 × 5 cm complex cyst with a thickened wall on the right ovary. The radiological findings were suggestive of an ovarian cystadenoma; multiple intramural and subserosal uterine leiomyomas were also noted. A total abdominal hysterectomy (TAH) and bilateral salpingo‐oophorectomy (BSO) was performed. Histopathological findings identified an atypical proliferative borderline Brenner tumor of the right ovary. Postoperative recovery was uneventful, the patient was discharged and managed conservatively postoperatively.

Diagnostic Challenges and Surgical Management of Ovarian Hydatid Cyst: A Case Report From an Endemic Region and Literature Review

ABSTRACT Ovarian hydatid cysts are an infrequent presentation of the zoonotic condition caused by Echinococcus granulosus tapeworms. These cysts can easily be mistaken for benign or malignant ovarian neoplasms, posing a diagnostic challenge. This case report describes managing a case of ovarian hydatid cyst in an endemic region. A 50‐year‐old woman, who had previously undergone surgery for a liver hydatid cyst, presented with abdominal pain and amenorrhea. Upon further investigations, it was revealed that a multilocular cystic lesion was in her left ovary through ultrasonography and computed tomography. Tumor markers were within normal limits. Intraoperative evaluation confirmed the diagnosis of a hydatid cyst, leading to a decision for a total abdominal hysterectomy with bilateral salpingo‐oophorectomy. The surgery was performed to remove the cyst safely. Following the procedure, the patient received anthelmintic therapy with albendazole. The outpatient follow‐up was focused on monitoring the patient's recovery and response to treatment. In conclusion, ovarian hydatid cysts are a rare entity that can mimic ovarian neoplasms, particularly in endemic regions. A high index of suspicion, along with appropriate imaging and histopathological examination, is crucial for accurate preoperative diagnosis. Surgical management, combined with perioperative anthelmintic therapy, is the mainstay of treatment to minimize the risk of recurrence and complications. Clinicians should be vigilant in considering hydatid disease as a differential diagnosis for cystic ovarian masses in endemic regions, even in the absence of a known history of the disease.

A Rare Case of Large Ovarian Thecoma Diagnosed Histopathologically Following Surgical Management in a Premenopausal Woman: A Case Report and Review of the Current Literature

ABSTRACT Ovarian thecomas are rare sex cord‐stromal tumors of the ovary. These tumors are estimated to account for 1% of all ovarian neoplasms. Thecomas are primarily composed of cells that resemble theca cells, which are involved in estrogen production. While thecomas are more frequently observed in postmenopausal women, they can also occur in premenopausal women. This report presents a rare case of an ovarian thecoma in a premenopausal woman and reviews the current literature on the topic. Herein we endeavor to contribute to the current body of knowledge and provide guidance to clinicians managing similar cases. Our patient is 43 years old and was diagnosed with an ovarian thecoma after she presented to our facility complaining of abdominal pain and abdominal distension. She underwent a total abdominal hysterectomy and unilateral salpingo‐oophorectomy. Histopathological examination confirmed a benign thecoma. We demonstrate that it is crucial to consider this benign condition when evaluating solid ovarian tumors in premenopausal women.

Breast Fibromatosis in a Patient With a History of Treated Breast Cancer: A Case Report

ABSTRACT Desmoid tumors are benign mesenchymal neoplasms that originate from muscular fasciae and aponeuroses. Breast involvement is exceptionally rare, accounting for less than 0.2% of all breast tumors. A 41‐year‐old woman with a history of right‐sided invasive ductal carcinoma (IDC) diagnosed in 2022 underwent breast‐conserving surgery (BCS) and axillary lymph node dissection (ALND), followed by adjuvant chemotherapy, radiotherapy, and daily tamoxifen (20 mg). The tumor measured 3.5 cm at its greatest dimension, was grade 2, estrogen receptor (ER)–positive, progesterone receptor (PR)–positive, HER2 negative, and had a Ki‐67 proliferation index of 25%. Histologic examination revealed a cribriform growth pattern without associated ductal carcinoma in situ (DCIS) or lymphovascular invasion (LVI), and one of nine axillary lymph nodes was positive for metastasis. In 2023, a total abdominal hysterectomy with bilateral salpingo‐oophorectomy was performed for ovarian suppression. During routine surveillance in 2024, a new mass was detected at the 2 o'clock position in the right breast. Two core needle biopsies performed over 6 months confirmed fibromatosis. Ongoing tumor enlargement and severe pain, despite radiotherapy, led to a wide local excision. Breast fibromatosis can closely mimic carcinoma both clinically and radiologically, and histologic analysis remains essential for definitive diagnosis. Complete surgical excision with negative margins remains the treatment of choice.

Bilateral Ovarian Hemangiomas Presenting With Abnormal Uterine Bleeding: A Rare Case Report

ABSTRACT Ovarian hemangiomas are rare benign vascular tumors that can present with abnormal uterine bleeding and mimic malignant ovarian lesions. Imaging may be inconclusive, and histopathology remains essential for diagnosis. This case highlights the importance of considering ovarian hemangiomas in the differential diagnosis of pelvic masses to ensure appropriate management.