Ovarian Female Adnexal Tumor of Probable Wolffian Origin, A Rare Gynecological Tumor in a 40-Year-Old patient: A Case Report

Articles in Press

Document Type : Case report

Authors

1 Pathology department; faculty of medicine; Mashhad university of medical science; Mashhad; Iran

2 Pathology department; faculty of medicine; Mashhad university of medical science, Mashhad, Iran

3 Pathology department , Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran

10.22038/ijogi.2025.80114.6097

Abstract

Introduction: Female adnexal tumor of probable Wolffian origin is a rare gynecological neoplasm that arises from Wolffian duct remnants. It affects patients aged 13 to 83 years old, with the most common site of the tumor being the broad ligament. However, it can also involve the ovaries, retroperitoneal space, pelvic wall, and even men. Most patients are asymptomatic, and the tumor is typically found incidentally during an examination or surgery.

Case Presentation: An asymptomatic 40-year-old woman found a mass in her right ovary on abdominal ultrasound four years ago; but did not seek any follow-up. After four years, she presented with a two-month history of refractory frequency. MRI revealed an 8 cm mass in her right ovary, causing pressure on the bladder. The patient underwent surgery and was initially diagnosed with Germ Cell Tumor and Ovarian Carcinoid. However, further microscopic evaluation showed a neoplastic lesion composed of cords, microfollicular, and insular patterns with small cuboidal to polygonal cells with scant cytoplasm and eosinophilic intraluminal secretion. Three mitoses per 10 HPF were observed, leading to the definitive diagnosis of Female Adnexal Tumor of Probable Wolffian Origin. The patient was discharged and advised to undergo sonographic follow-up.

Conclusion: Given the various differential diagnoses of Wolffian tumors, it is crucial to consider it in any gynecological neoplasm regardless of the patient's age. This tumor has the potential for malignancy, recurrence, and metastasis, highlighting the importance of regular follow-up.

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The Iranian Journal of Obstetrics, Gynecology and Infertility

Articles in Press, Accepted Manuscript
Available Online from 18 January 2025

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