Abstract
The coexistence of three histologically distinct ovarian tumors is exceedingly rare, posing challenges for accurate diagnosis and management. This case report presents a young woman with concurrent endometriotic cyst and fibroma in one ovary, as well as a mature cystic teratoma in the other. Surgical priority centered on completely removing the tumors while preserving healthy ovarian tissue. While the dermoid and endometriotic cysts were excised completely through laparoscopy, a laparotomy was necessary to excise the firm, irregular mass (fibroma) and conserve the remaining ovarian tissue. Although laparoscopy is advantageous for removing benign masses, laparotomy may be required for ovarian preservation in patients with multi-pathological involvement of both ovaries.