Ovarian fibromas belong to a class of benign sex cord-stromal cell tumours comprised of spindle-shaped fibroblastic cells and collagen and represent 4% of all ovarian neoplasms.[1,2,3] Ovarian fibromas most frequently occur in middle-aged women, with an average age at diagnosis of 48 years.[2,4] Fibromas are typically slow-growing and can grow from initially small to very large tumours.

The clinical presentation can be nonspecific and may include a pelvic mass, metrorrhagia, and abdominal pain or distension.[5] Small tumours are frequently asymptomatic. As the mass slowly increases in size, the affected individual will complain of pelvic discomfort to acute abdominal pain.[2] 

On CT images, an ovarian fibroma usually appears as a homogeneous solid ovarian mass with delayed contrast enhancement.[2] Cystic changes may occur in fibromas as a degenerative change.[6,7] Cystic degeneration and haemorrhage are common, and calcifications may also be widespread throughout the tumour.[2,6] Ovarian fibromas may also be associated with ascites and pleural effusion, a condition known as Meigs Syndrome.[2,4]

Cystic degeneration, calcification, pleural effusion, and ascites are also present in other types of disorders, which may lead to the misdiagnosis of a fibroma as another type of ovarian neoplasm. Therefore, knowledge of appropriate CT imaging techniques is an important factor in establishing the correct diagnosis.