Finch et al. Journal of Medical Case Reports 2012, 6:148 http://www.jmedicalcasereports.com/content/6/1/148 Page 4 of 5 Figure 2 Examination of the gross specimen. (A) Gross image of ovarian fibroma. (B) Photomicrograph of ovarian fibroma. (C) Photomicrograph of ovarian fibroma showing calcifications. (D) Photomicrograph of ovarian fibroma, high power. (E) Smooth muscle actin positivity. (F) Vimentin positivity. an intersecting bundle or storiform architecture, as is seen in our case. An edematous fibroma can be mistaken for massive ovarian edema or ovarian fibromatosis [10]. Typical fibromas contain a mitotic rate of three or less per 10 high power fields and no cellular atypia, which was also seen in our case. Ovarian fibromas in Gorlin syndrome are considered benign [2], although develop- ment of fibrosarcoma within existing bilateral ovarian fi- bromas has been reported [8]. Management involves conservative excision with an attempt at ovarian func- tional preservation. Ovarian fibromas rarely recur after surgery [11]. Techniques such as egg retrieval and embryo cryo- preservation are useful for patients requiring complete bilateral oophorectomy and desiring future children, as was offered to the patient in our case. The patient should undergo genetic counseling because Gorlin syn- drome is an autosomal dominant condition [12]. Chil- dren of patients with the syndrome should be investigated for clinical manifestations. Conclusion We report the case of a patient with Gorlin syndrome who did not have any skin lesions and presented with a unilateral ovarian fibroma. Nevoid basal cell carcinoma syndrome, or Gorlin syndrome, is a rare multisystem disorder with multiple developmental anomalies and an increased risk of developing assorted benign and malig- nant tumors. Skin lesions are not necessary for the diag- nosis of Gorlin syndrome and ovarian fibromas are typically bilateral in the syndrome. Ovarian fibromas are managed with surgical excision with an attempt at pre- serving ovarian function. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for re- view by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests.