Unusual presentation of ovarian cellular fibroma coexisting with nodular sclerosing Hodgkin's disease: a case report and review of the literature

A case of a nonfunctioning, noncalcified ovarian cellular fibroma in a 15-year-old adolescent girl is described. The fibroma was found incidentally in a patient who was later found to have nodular sclerosing Hodgkin's disease. The patient presented with symptoms suggestive of lymphoma but on exam was found to have a mobile and nontender abdominal mass. Laparotomy exposed a smooth, well-circumscribed left ovarian mass. A left salpingoophorectomy was performed. The mass weighed 2390 g and measured 19 × 15 × 8.5 cm. Approximately 15% of the tumor was composed of large cellular nodules identified as spindle cells having a storiform pattern. Mild nuclear atypia with 2 mitosis per 10 high-power fields was noted. An ovarian fibroma in a 15-year-old is an unexpected diagnosis. Less than 1% of ovarian stromal tumors are found in patients 19 years and younger. The uncommon histology and additional classification as a cellular fibroma as well as the simultaneous diagnosis of 2 neoplasms in this case are remarkable.