This video demonstrates the diagnostic dilemma of solid ovarian masses. Ovarian fibromas are frequently mistaken for uterine fibroids on ultrasonography. They are also misdiagnosed as malignant ovarian neoplasms on clinical assessment and surgical intervention.

Laparoscopy of this case showed many criteria of ovarian malignancy. The ovarian solid mass with a diameter of 10 cm showed increased vascularity, areas of haemorrhage, exophytic lesions, in addition to ascites.

The aim of this video is to show how a twisted ovarian fibroma mimic ovarian cancer. Furthermore, the acute abdominal pain resulting from its torsion reduces the time for better clinical, radiological and biochemical evaluation and the emergency situation diminishes the chance to perform an intra-operative frozen section to rule out the differential diagnosis.