A case report of bilateral benign Ovarian Fibrothecoma coincidental with ascites: an unconventional co-occurrence.

Ovarian fibrothecoma are a mostly benign and profoundly rare type of gonadal stromal cell tumor. It makes up 3-4% of all kinds of ovarian neoplasia. They are predominantly unilateral in origin and mostly present in women during the postmenopausal phase. Our case is especially important because the tumors occurred bilaterally and were associated with ascites. This seldom happens in patients with ovarian fibrothecoma. Early identification and treatment are key components to avoid the subsequent complications of this tumor. Case presentation: We present the case of a 54-year-old female who presented complaining only of a slow progressive increase in the abdominal contour associated with vague abdominal pain. Our preoperative radiological imaging revealed multiple ovarian and uterine masses. Clinical discussion: Surgical intervention in the form of a hysterectomy with bilateral salpingo-oophorectomy was achieved. Histopathological analysis revealed bilateral benign ovarian fibrothecoma with benign uterine leiomyomas. The patient underwent an uneventful postoperative recovery. Conclusion: Ovarian Fibrothecoma is a rare gynecological pathology. The uniqueness of our case stems from the rarity of its bilateral occurrence and in rare occasions, their occurrence is accompanied by ascites. This kind of co-occurrence should be differentiated from other rare presentations, such as Meigs Syndrome. Therefore, documentation is necessary to circumvent misdiagnoses and to abate the resulting patient morbidity. To further highlight the value of our case, it is to the best of our knowledge, the first documented case of this pathology from our country.

A rare case of a male Choledochal Cyst with an ambiguous distal end incidentally discovered in adolescence.

INTRODUCTION AND IMPORTANCE: A choledochal cyst is a rare congenital biliary tract pathology. It displays an evident dilation that could arise in any part along the biliary tree. Its incidence rate reflects its rarity when it takes place in 1 per 100,000-to-150,000 newborns. 75 % of them are detected in early childhood, whereas around 20 % are identified and diagnosed in adulthood. The gender-specific predominance favors females over males with an almost 4:1 ratio. Our case is of an adolescent male, and this constitutes a rare variant of the previous criteria. Furthermore, the distal end of the common bile duct could not be identified. CASE PRESENTATION: We present the case of a 15-year-old previously healthy male, who presented to our surgical clinic complaining of chronic dull aching pain in the right hypochondrium. Preoperative radiological analysis revealed a choledochal cyst. CLINICAL DISCUSSION: Surgical intervention was achieved to excise the lesion and comprehensive histopathological analysis was a key element to establish a definitive diagnosis. CONCLUSION: Choledochal cysts are rare biliary anomalies. Its non-specific symptoms lead to misdiagnosis. Consequently, suitable clinical evaluation escorted by comprehensive radiological imaging is essential to suspect this pathology and swiftly treat it. This anomaly predominantly occurs in females and is chiefly discovered during childhood. Our case is a prime exception to this norm. To the best of our knowledge, this is the first documented case from Syria of an adolescent male affected by a Type I choledochal cyst with an ambiguous end of the distal common bile duct.