Solitary fibrous mass of the omentum mimicking an ovarian tumor: case report

There are some pelvic masses which are difficult to correctly classify as malignant or benign. The decision concerning method and choice of surgical intervention is not simple in this situation. Some tumors are extremely rare and need to be presented in the literature. The authors report a rare case of fibrous tumor of the omentum simulating a malignant ovarian tumor, which ultimately resulted to be a primary solitary fibrous tumor of the omentum. Ultrasound findings are mostly precise prognostic tools according ovarian masses. However, from time to time, Doppler blood flow examination may present false positive results.

Ovarian cancer; Solitary fibrous tumor; Ultrasonography.

[1] Daemen A., Valentin L., Fruscio R., Van Holsbeke C., Melis G.B., Guerriero S., et al.: “Improving the preoperative classification of adnexal masses as benign or malignant by second-stage tests”. Ultrasound Obstet. Gynecol., 2011, 37, 100.

[2] Sokalska A., Timmerman D., Testa A.C., Van Holsbeke C., Lissoni A.A., Leone F.P., et al. Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses. Ultrasound Obstet. Gynecol., 2009, 34, 462.

[3] Timmerman D., Testa A.C., Bourne T., Ferrazzi E., Ameye L., Konstantinovic M.L., et al.: “Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group”. J. Clin. Oncol., 2005, 23, 8794.

[4] Szpurek D., Moszynski R., Zietkowiak W., Spaczynski M., Sajdak S.: “An ultrasonographic morphological index for prediction of ovarian tumor malignancy”. Eur. J. Gynaecol. Oncol., 2005, 26, 51.

[5] Szpurek D., Moszyniki R., Sajdak S.: “Clinical value of the ultrasound Doppler index in determination of ovarian tumor malignancy”. Eur. J. Gynaecol. Oncol., 2004, 25, 442.

[6] Valentin L., Ameye L., Savelli L., Fruscio R., Leone F.P., Czekierdowski A., et al.: “Adnexal masses difficult to classify as benign or malignant using subjective assessment of gray-scale and Doppler ultrasound findings: logistic regression models do not help’. Ultrasound Obstet. Gynecol., 2011, 38, 456.

[7] Timmerman D., Schwarzler P., Collins W.P., Claerhout F., Coenen M., Amant F., et al.: “Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of interobserver variability and experience”. Ultrasound Obstet. Gynecol., 1999, 13, 11.

[8] Alcazar J.L., Merce L.T., Laparte C., Jurado M., Lopez-Garcia G.: “A new scoring system to differentiate benign from malignant adnexal masses”. Am. J. Obstet. Gynecol., 2003, 188, 685.

[9] Ishida H., Ishida J.: “Primary tumours of the greater omentum”. Eur. Radiol., 1998, 8, 1598.

[10] Hasegawa T., Matsuno Y., Shimoda T., Hasegawa F., Sano T., Hirohashi S.: ‘Extrathoracic solitary fibrous tumors: their histological variability and potentially aggressive behavior”. Hum. Pathol., 1999, 30, 1464.

[11] Goff B.A., Mandel L.S., Drescher C.W., Urban N., Gough S., Schurman K.M., et al.: “Development of an ovarian cancer symptom index: possibilities for earlier detection”. Cancer, 2007, 109, 221.

[12] Timmerman D., Valentin L., Bourne T.H., Collins W.P., Verrelst H., Vergote I.: “Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group”. Ultrasound Obstet. Gynecol., 2000, 16, 500.

[13] Witczak K., Szpurek D., Moszynski R., Sroka L., Sajdak S.: “Clinical assessment of selected vascularization attributes of adnexal masses in preoperative prediction of tumor malignancy”. Ginekol. Pol., 2007, 78, 373.

[14] Soufi M., Mdaghri J., Benamr S., Lahlou M.K., Massrouri R., Essadel A., et al.: “Giant liposarcoma of the omentum mimicking an ovarian tumor. A case report”. Indian J. Surg., 2012, 74, 425.

[15] Ono M., Tanaka K., Ikezawa N., Kobayashi Y., Inoue Y., Yokota M., et al.: “Fibroma of the omentum resembling an ovarian tumor in the pelvis”. Keio J. Med., 2009, 58, 234.

[16] Imachi M., Tsukamoto N., Tsukimori K., Funakoshi K., Nakano H., Shigematsu T., et al.: “Malignant hemangiopericytoma of the omentum presenting as an ovarian tumor”. Gynecol. Oncol., 1990, 39, 208.

[17] Ahmad G.F., Athavale R., Hamid B.N., Davies-Humphreys J.: “Pelvic malignant hemangiopericytoma mimicking an ovarian neoplasm; a case report”. J. Reprod. Med., 2004, 49, 404.