Ovarian Fibroma as a Possible Cause of Fever of Unknown Origin

Fibromas are the most common benign solid tumors of the ovary. Clinically, they are asymptomatic and preoperative diagnosis is often difficult. In this paper we report a case of fibroma as a cause of fever of unknown origin (FUO). A 26-year-old woman referred to our hospital with a one-month history of intermittent fever. Ultrasonography as well as pelvic computed tomography scans showed a hypoechoic appearance in the right adnexal region which was diagnosed as pyosalpinx, in the light of clinical setting. Pus drainage was then planned but 3cc of serous material was drained from the adnexal mass with ultrasound-guide. Despite antibiotic therapy, her fever continued. She had a comprehensive work-up for FUO, including rheumatologic, infectious, and malignant etiologies. Magnetic resonance imaging (MRI) scans of the pelvis showed two well defined ovarian lesions, which were suggestive of an ovarian fibroma. MRI findings that are suggestive of gynecological infectious diseases were not detected. Then laparoscopy was scheduled. The patient responded well to surgery and the fever resolved after surgery. She is now in the ninth postoperative month and still has no fever.