Case Report:
A 40-year-old female, P1, L1 without comorbidity, was presented with fullness of the abdomen for three months and nonspecific pain abdomen on and off for one month. Computed tomography scan showed a large cystic lesion 9 cm x 8.3 cm with peripheral enhancing nodule soft tissue component in the left adnexa. The serum cancer antigen-125 (CA-125) was 389.8 ยต/ml with a suspicious diagnosis of ovarian malignancy. The patient underwent laparotomy with left ovariotomy and was sent for frozen biopsy, which revealed borderline ovarian malignancy, and thus surgery was extended to total abdominal hysterectomy with bilateral salphingo-opophorectomy with bilateral pelvic and paraaortic lymph node dissection with total omentectomy and multiple peritoneal sampling. The diagnosis of a borderline serous tumor of the left ovary was established after the evaluation of the surgical specimen in the Pathology department. On gross examination, a small gray yellow soft mass on the right ovary was seen. The lesion was well-circumscribed and measured 1 cm x 0.7 cm x 0.6 cm. The outer surface was smooth, intact and the cut surface was solid, yellow, and homogeneous. [Figure-1] Areas of hemorrhage, necrosis were not appreciated. The microscopic picture showed the presence of a well-circumscribed lesion consisting of matured adipocytes along with a few interlacing fibrous bands in between and thin-walled capillary-sized blood vessels. The final diagnosis of ovarian lipoma of the right ovary was made. Features of malignancy, borderline tumor or teratoma in the right ovary were not seen. [Figure-2A and 2B]