DOI: https://doi.org/10.36347/sasjm.2025.v11i12.013

Pages: 1210-1213

Supernumerary ovaries are exceptionally rare congenital anomalies defined by the presence of functional ovarian tissue entirely separate from the normal ovaries. Although usually asymptomatic, they may give rise to cysts, endometriosis, or neoplasms, with tumors arising from supernumerary ovaries reported only in a limited number of cases. We present the case of a 49-year-old woman who presented with right-sided pelvic pain and was found to have two contiguous cystic masses in the right latero-uterine region, distinct from the eutopic ovaries, which appeared normal on imaging. MRI suggested benign multiloculated cystic formations, but the markedly elevated CA-125 level [13 469 U/mL] raised suspicion for malignancy. Exploratory laparotomy revealed two cystic formations connected to the uterus by a vascularized cord, consistent with a supernumerary ovary. Histopathology confirmed a benign serous cystadenoma, and peritoneal cytology and biopsies were negative. This case illustrates the diagnostic challenges posed by ectopic ovarian tissue, particularly when tumor markers are misleadingly elevated and imaging cannot establish the origin of the mass. Awareness of this rare anomaly is essential to avoid misdiagnosis and to guide appropriate surgical management.