Bilateral Ovarian Fibromas with Duplex Collecting System and Ectopic Ureter in an 11-Year-Old Girl: A Case Report with Genetic Analysis

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Abstract
Background: Bilateral ovarian fibromas in children are exceedingly rare. Their coexistence with congenital anomalies of the kidney and urinary tract (CAKUT) has not been reported.Case presentation: An 11-year-old girl presented with abdominal pain and lifelong urinary dribbling. Imaging revealed bilateral ovarian masses and a left duplex collecting system with a dilated upper-pole ureter inserting ectopically into the posterior urethra. Serum tumor markers including CA125 were within normal limits. No ascites or peritoneal deposits were identified. Laparoscopic bilateral tumor excision preserved normal ovarian tissue; histopathology confirmed ovarian fibromas with low proliferative index. Three months later, laparoscopic excision of the ectopic distal ureteral segment and ipsilateral ureteroureterostomy completely resolved urinary symptoms. Trio whole-exome sequencing identified heterozygous variants of uncertain significance (VUS) in SUFU (p.Asp182Asn) and FN1 (p.Asn649Ile), both inherited from unaffected parents. At 12-month follow-up, the patient had spontaneous menarche with preserved ovarian function.Conclusions: This single-case report documents an unprecedented dual genitourinary presentation that expands the clinical spectrum of pediatric ovarian fibromas. The identified SUFU and FN1 variants, though classified as VUS requiring functional validation, suggest possible shared mesodermal developmental susceptibility. Fertility-preserving surgery combined with staged urologic reconstruction achieved full functional recovery.
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Authors Gui, Meng
Journal Frontiers in surgery
Year Year not found
DOI
10.3389/fped.2026.1765709
URL
https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1765709/full
Keywords Keywords not found

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