A rare case of an accessory ovary
The present case has been reported in the Indian Journal of Pathology and Microbiology.

A 40-year-old woman came with the complaints of abdominal distension and chronic pelvic pain for 6 months. Ultrasonography showed a large cystic mass in the left adnexa. Total hysterectomy with bilateral salpingo-oophorectomy was performed.

On gross examination of the surgical specimen, it was found that the endometrium, myometrium, cervix, and right adnexa were unremarkable. The left adnexa showed two ovaries and a fallopian tube. A large, serous fluid-filled cyst measuring 12 cm × 9 cm was noted in the left eutopic ovary.

On microscopic examination, the endometrium, myometrium, cervix, and right adnexa showed normal histomorphology. Sections studied from accessory ovary showed normal histomorphological features. The cyst in the left eutopic ovary was diagnosed as serous cystadenoma on microscopy. Further inspection and ultrasonography revealed no other genitourinary or pelvic anomaly.

Clinical Pearls:-
- Accessory ovary is defined as a third ovary which has close proximity and some form of association with eutopic ovary and its blood supply.

- As accessory ovaries develop from abnormal embryogenesis, congenital anomalies, or genetic defects are often associated with them. These malformations include accessory fallopian tube, bicornuate uterus, and renal agenesis.

- The accessory ovaries have both the functional and pathological potentials of normal ovaries. There are reports of tumors such as mature cystic teratoma, serous cystadenoma, mucinous cystadenoma, Brenner tumor, steroid cell tumor, sclerosing stromal tumor, and fibroma arising from accessory ovaries.

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