title: Mitotically active cellular ovarian fibroma with Meigs' syndrome and elevated CA-125: towards fertility preservation.
abstract: BACKGROUND
  Meigs syndrome is rare in women under 30 years of age and even more if associated with an elevated CA-125. In this case, malignancy was suspected and raised concerns about fertility preservation.
  
  
  METHODS
  A 13-year-old girl presented with a 4-month amenorrhea, abdominal enlargement and dyspnea. Ultrasonography showed a 14-cm solid mass with ascites, bilateral pleural effusion and, analytically, elevated serum CA-125. Unilateral salpingo-oophorectomy was performed, with a 19 × 15 × 12 cm mass being disclosed from the right ovary. Final pathology diagnosed a mitotically active cellular ovarian fibroma (MACF), with no significant nuclear atypia.
  
  
  CONCLUSIONS
  MACF is a recent histopathologic entity. Despite the high count of mitotic figures, it is not associated with atypia, which contributes to favorable outcome. Although initial suspicions of malignancy, a conservative surgical intervention allowed fertility preservation. This was clinically appropriate and with no implications on survival and prognosis of these patients.
authors.affiliation: Department of Obstetrics and Gynecology, São João Hospital, Porto, Portugal. sofiambessa@sapo.pt
authors.forename: Sofia B
authors.initials: SB
authors.lastname: Monteiro
authors.forename: Antónia
authors.initials: A
authors.lastname: Costa
authors.forename: Vera
authors.initials: V
authors.lastname: Paiva
mesh_terms: D000293:Adolescent; D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D059247:Fertility Preservation; D005350:Fibroma / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008539:Meigs Syndrome / Q000097:blood*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery*; D058994:Salpingectomy; D014057:Tomography, X-Ray Computed
chemical_list: D018394:CA-125 Antigen