Sclerosing stromal tumor of the ovary: A report of two cases with distinct features.

introduction and importanceSclerosing stromal tumor (SST) is a rare, benign ovarian neoplasm affecting women in their second and third decades. Despite being benign, it often mimics malignant ovarian tumors on imaging, making preoperative diagnosis challenging. Recognizing SST is crucial for appropriate surgical planning, particularly in fertility-preserving interventions for young women. CASE PRESENTATION: Case 1: A 28-year-old multiparous woman presented with abdominal distension and oligomenorrhea. Ultrasound showed a left ovarian mass. Laparotomy with left salpingo-oophorectomy revealed SST features, including pseudolobulation and thin-walled vessels. Her postoperative recovery was uneventful with normalized menstrual cycles. Case 2: A 19-year-old nulliparous woman presented with abdominal pain, distension, and mild dyspnea. Imaging showed a right ovarian mass with ascites. Laparotomy with right oophorectomy revealed a solid yellowish mass confirmed as SST on histopathology. She recovered well with no recurrence at 6 months. CLINICAL DISCUSSION: SST accounts for less than 6 % of sex cord-stromal tumors, characterized by pseudolobulation, heterogeneous cellularity, and vascularity. Differential diagnoses include fibroma, thecoma, and granulosa cell tumor. While imaging may suggest SST, histopathology is definitive. Surgical excision is curative, and fertility-sparing options are viable for young patients.

conclusionSST should be considered in the differential diagnosis of solid ovarian masses in young women. Although imaging supports preoperative suspicion, histological evaluation is definitive. Conservative surgery ensures an excellent prognosis and fertility preservation.