A rare case report of ovarian myxoma in a 23-year-old woman: Diagnosis and treatment

Document Type : Case report

Authors

1 Professor, Department of Pathology, Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/ijogi.2025.86060.6358

Abstract

Introduction: Ovarian myxoma is a rare benign neoplasm with specific features among ovarian tumors. It may be confused with other ovarian masses due to its histological similarities to edematous fibromas and myxoid sarcomas. In this paper, a rare case of ovarian myxoma is reported.
Case presentation: The patient was a 23-year-old woman presented with worsening chronic abdominal pain to the emergency department of Imam Reza hospital. Ultrasound showed a complex cystic structure with homogeneous echo, smooth and regular external borders, measuring 177×133×92 mm and an approximate volume of 1150 ml in the adnexa, while the left ovary was not visible separately. CT scan showed a cystic focus with peripheral enhancement in the post-contrast phase with a nodular margin measuring 126×161×88 mm adjacent to the upper border of the uterus and bladder. Blood biochemical tests were in normal ranges and the BHCG hormonal test was negative. Among the tumor markers, CA125 was high. According to these observations, the mass was removed by surgical procedure. In the macroscopic examination, the ovarian mass, measuring 8×12×16 cm, was solid cystic with a myxoid appearance and extensive foci of hemorrhage. In microscopic examination, sections of myxoid neoplasm with a solid and lobular growth pattern made of round to spindle cells with mild atypia without notable mitosis and necrosis were observed, and abundant small chicken wire vasculature was observed in the background tissue. Immunohistochemical examination was positive only for actin.
Conclusion: This study, which is the first report of ovarian myxoma in Iran, shows that nonspecific clinical presentation of this tumor may lead to misdiagnosis and longer progress of the disease. Therefore, in similar cases, imaging findings should be obtained, followed by histopathology and immunohistochemistry tests to diagnose the disease definitively.

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 1
March 2025
Pages 78-84

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