A BENIGN SPINDLE CELL TUMOR-UNCOMMON CAUSE OF ADNEXAL MASS

Sri Vasavi CH; Nandini S; Munikrishna M

doi:10.37022/jcscr.v5i1.898

Sri Vasavi CH Department of Obstetrics and Gynaecology, Sri Devaraj Urs Academy of Higher Education and Research, R L Jalappa Hospital & Research Centre, Tamaka, Kolar, Karnataka, India
Nandini S Department of Obstetrics and Gynaecology, Sri Devaraj Urs Academy of Higher Education and Research, R L Jalappa Hospital & Research Centre, Tamaka, Kolar, Karnataka, India
Munikrishna M Department of Obstetrics and Gynaecology, Sri Devaraj Urs Academy of Higher Education and Research, R L Jalappa Hospital & Research Centre, Tamaka, Kolar, Karnataka, India

DOI https://doi.org/10.37022/jcscr.v5i1.898

Abstract

Due to the higher risk of cancer, adnexal masses in postmenopausal women are clinically relevant. Aggressive surgical intervention and thorough histological investigation are frequently required when radiological findings reveal ovarian cancer. Adnexal benign spindle cell tumours are extremely rare and can resemble malignant ovarian neoplasms both radiologically and clinically. We report the case of a 69-year-old postmenopausal lady who complained of lower abdomen pain and had a big right adnexal tumour with imaging characteristics that could indicate ovarian cancer. A heterogeneous enhancing adnexal lesion with loss of fat planes and accompanying lymph nodes that seemed necrotic was shown by contrast-enhanced computed tomography. The patient had an appendicectomy, infracolic omentectomy, bilateral salpingo-oophorectomy, and total abdominal hysterectomy. Intraoperative frozen section analysis revealed a benign spindle cell lesion, and conclusive histological analysis verified leiomyoma originating from the adnexal region with hyalinization and cystic degeneration. The time following surgery was uneventful. This case demonstrates the difficulty in diagnosing uncommon benign spindle cell tumours of the adnexa and the critical role histology plays in distinguishing benign lesions from gynaecologic cancers.

Keywords: Adnexal mass, Benign spindle cell lesion, Leiomyoma, Postmenopausal woman, Ovarian malignancy mimic, Histopathology, Frozen section

References

Particularly in postmenopausal women, benign spindle cell leiomyomatous lesions of the adnexal region are extremely uncommon and can closely resemble ovarian cancer on imaging studies. These tumours' degenerative alterations could make radiological interpretation even more challenging. For a conclusive diagnosis, histopathological examination-including intraoperative frozen section analysis-remains essential. To prevent diagnostic mistakes and provide appropriate surgical care, it is crucial to be aware of such rare benign entities.
Patient Perspective
The patient experienced significant anxiety after being informed about the possibility of ovarian malignancy based on imaging findings. Following surgery and histopathological confirmation of a benign lesion, she expressed relief and satisfaction with the treatment outcome and postoperative recovery.
INFORMED CONSENT
Written informed consent was obtained from the patient for publication of this case report and associated clinical details while maintaining anonymity.

CONFLICT OF INTEREST
The authors declare no conflict of interest.

FUNDING
No financial support or external funding was received for this study.

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