Abstract:

Ovarian sclerosing stromal tumor （OSST） is a benign tumor originating from the ovarian sex cord-stroma， accounting for only 2%-6% of ovarian stromal tumors. It predominantly occurs in young women， and cases of OSST concurrently presenting with Meigs syndrome are extremely rare. This study reports a case of OSST， summarizes its clinical manifestations， and reviews relevant literature. The patient， a 22-year-old female， was admitted due to abdominal distension for 2 months， worsening over the past week. The physical examination results revealed abdominal distension， shifting dullness， mild tenderness， and no muscle tension or rebound tenderness. A mass measuring approximately 16.0 cm×14.0 cm×8.0 cm was palpated in the pelvic and abdominal cavity， with a firm texture， moderate mobility， and no tenderness. The gynecological ultrasound results showed a mixed cystic-solid echo of about 15.3 cm×14.0 cm×8.4 cm above the left side of the uterus， with clear boundaries， and fluid-filled dark areas in the pelvic and abdominal cavity， with a maximum anteroposterior diameter of about 11.9 cm. The-CT results revealed a cystic-solid mixed-density mass in the lower abdomen and right adnexal area， suggestive of a neoplastic lesion， with increased glucose metabolism in the solid portion， leaning toward malignancy. Carbohydrate antigen 125 （CA125） was >800 U·mL^-1， and pelvic puncture cytology indicated no cancer cells. The findings suggested a benign or borderline ovarian tumor， requiring differentiation from ovarian malignant tumors. Based on intraoperative observations and rapid pathological results， a left ovarian tumor enucleation was performed. Postoperative pathology confirmed ovarian sclerosing stromal tumor. Follow-up over 2 years showed no abnormalities. As a benign ovarian tumor， the clinical manifestations of OSST often mimic those of malignant tumors， leading to frequent misdiagnosis. Early diagnostic accuracy should be improved to develop the optimal treatment plan for patients.

Key words: Ovarian sclerosing stromal tumor, Ovarian malignant tumor, Meigs syndrome, Glucose metabolism, Misdiagnosis