Abstract
INTRODUCTION: Ovarian cystadenofibroma is a rare benign tumor of the ovary that presents unique diagnostic challenges for clinicians due to its resemblance to malignant neoplasms. PRESENTATION: We present the case of a 36-year-old female who presented with acute abdominal pain and imaging findings suggestive of a cystic ovarian neoplasm, later histopathologically confirmed as a cystadenofibroma. DISCUSSION: Ovarian cystadenofibroma may demonstrate lesser magnetic resonance imaging (MRI) T2 signal enhancement than cystadenocarcinofibromas ((CACFs), their malignant counterparts) aiding clinicians in their diagnosis. This case demonstrates the importance of considering benign ovarian neoplasms, such as ovarian cystadenofibroma, in the differential diagnosis of complex ovarian masses - despite radiological and clinical features suggestive of malignancy. CONCLUSION: Accurate preoperative diagnosis is essential for guiding appropriate surgical management.