Aim and background: Sclerosing stromal tumors (SST) are a rare ensemble of benign ovarian neoplasms, constituting approximately 6% of the realm of sex-cord stromal tumors. They are mostly seen in young females in second and third decade of life as solid unilateral tumors mimicking a malignancy. Thus, pre-operative diagnosis is a challenge and over-treatment is common.

Case description: A menopausal woman in her mid forties came with peri-umbilical pain, found to have an 8 x 5 cm firm to cystic mass anterior to the uterus. While USG was suggestive of an ovarian neoplasm, CECT findings related it to a subserosal uterine fibroid. During laparotomy frozen section of ovarian mass was reported as intermediate to malignant grade tumour and hence a complete surgical staging was performed. The final histopathology and IHC confirmed the diagnosis of sclerosing stromal cell tumor of the left ovary.

Conclusion: Pure SST is a rare benign tumor with difficult diagnosis due to imaging features resembling malignancy. For young patients, fertility preservation surgery should be the first choice in such tumors due to good prognosis.

Clinical significance: A differential diagnosis of benign SST should be considered for solid ovarian tumors in menopausal women. CECT and frozen section may not always be helpful and patients often undergo over-treatment. MRI may be a better imaging for diagnosing this tumor. Fertility preservation should be the treatment of choice, especially in young women.

Vallina Narang has completed her MBBS, MD (OBGYN), from King George’s Medical University, Lucknow. She has two years experience as Senior resident and 6 months as Assistant Professor post MD. Currently, she is working as a fellow in Gynaecology Endoscopy at Sri. Ramachandra Institute of Higher Education in Chennai. She is a compassionate healthcare professional known for high productivity and efficient task completion. Possess specialized skills in patient diagnosis, treatment plan development, obstetric and gynecological surgeries. She has co-authored a chapter on Endometrial cancers in EEBR by FOGSI and also a UG textbook chapter on ovarian cancer. She has published articles and case reports in both national and international journals.