Paratesticular cystadenomas remain a very rare entity, typically presenting as a painless mass, often indistinguishable from the testicle. As such, the predominant management seems to be complete excision via various approaches, which often proves curative. Given its rarity, post-operative surveillance has not been standardized; most patients and providers elect a more conservative surveillance approach. Based on the available literature, this seems appropriate, given the lack of morbidity or recurrence associated with these types of tumors.

Juvenile granulosa cell tumor (GCT) is a rare ovarian tumor in children, presenting with a multiloculated cystic pattern and irregular wall-thickening on imaging and serous cystadenoma (SCA) is also another rare benign cystic ovarian tumor in children. The appearance of two uncommon types of ovarian tumors on both sides in children is extremely rare. We report the case of a 4-year-old female presenting with symptoms of precocious puberty and diagnosed with juvenile GCT on the left ovary after surgical resection. However, during follow-up 1 year after GCT resection, she presented with another multiloculated cystic mass in the right ovary, and diagnosed as SCA after surgical resection and histopathologic evaluations. The appearance of cystic ovarian tumor after primarily GCT resection need to differentiate between the recurrence of the primarily GCT and other cystic ovarian tumors although it is very uncommon. Furthermore, the imaging features played a key role in the differential diagnosis between benign and malignant ovarian tumors.

Coexistence of situs inversus totalis and ovarian serous cystadenoma in pubertal girls is extremely rare. It is important to preserve ovarian hormonal physiology and fertility if it is detected in the pubertal period. A 16-year-old girl presented with abdominal distension and pain. Radiological evaluation revealed a huge abdominal cystic mass and situs inversus totalis. In laparotomy, unilateral salpingoophorectomy and total cystectomy were performed on the ovarian cystic mass. It was confirmed as serous cystadenoma in pathological evaluation. This is the first reported case in the literature of situs inversus totalis with a huge ovarian serous cystadenoma.

Most cases of female genital tuberculosis (TB) are asymptomatic and are thus difficult to diagnose. Coexistence of genital TB and ovarian serous cystadenofibroma (OSCAF) is rare and easily ignored or misdiagnosed. We report a 26-year-old woman with coexistence of genital TB and OSCAF, and with an adnexal mass detected by B-ultrasound. Laparoscopic biopsy of diffuse miliary white nodules was performed on the surface of the peritoneum and both fallopian tubes. Right ovarian cystectomy was performed. Postoperative pathology showed that the right ovarian mass was a benign serous cystadenofibroma, and both fallopian tubes and miliary white nodules on the surface of pelvic organs showed chronic granulomatous inflammation. Polymerase chain reaction for Mycobacterium tuberculosis and acid-fast bacilli culture were positive in biopsies of the fallopian tubes, omentum, and peritoneum. The patient received anti-TB treatment after surgery. Six months after the operation, the patient had no abdominal pain and no major changes in menstruation. Our findings suggest that a timely operation is required for patients with an adnexal mass. During surgery, even if the lesion is similar to a malignant tumor, the surgical approach needs to be cautiously chosen for young patients without children. The patient\'s postoperative fertility must be taken into consideration.

We report a very rare case of Peutz-Jeghers syndrome (PJS) composed of multiple genital tract tumors and mucinous adenocarcinoma. A 46-year-old woman presented to our hospital with lower abdominal pain resulting from PJS involves sex cord tumor with annular tubules (SCTAT), ovarian mucinous tumor, ovarian serous tumor, mucinous adenocarcinoma of colon. The CEA concentration is high before surgery, and decreases after the surgery and subsequent chemoradiotherapy. This case demonstrates a classic clinical presentation of a patient with PJS. PJS patients have increased risk of malignancy and early detection and regular surveillance of the high-risk patients with PJS is crucial. Surgery may be required for obstructive gastrointestinal lesions as well as those exhibiting malignant degeneration.