Serous Papillary Adenofibroma Cyst of the Ovary in a Young Woman: Case Report and Literature Review.

Background: Serous papillary adenofibroma cyst (SPAC) of the ovary is a rare benign epithelial tumor that can mimic borderline or malignant ovarian neoplasms. Reports in young women are particularly scarce. Purpose: The aim of this study is to present a rare clinical case of ovarian SPAC in a young woman and to review the existing literature, highlighting diagnostic challenges and implications for fertility-preserving management. Methods: We present a clinical case of ovarian SPAC in a 41-year-old woman and conducted a narrative literature review. The search was performed in PubMed, Scopus, and Web of Science to identify reports published between 2000 and 2025. Additional relevant articles were also identified through manual screening of reference lists from selected papers. Results: MRI revealed a well-encapsulated septated cystic lesion with solid nodular components and post-contrast enhancement. Tumor markers, including CA 19-9, were elevated. Laparoscopic surgery with intraoperative frozen section confirmed the diagnosis of SPAC, allowing fertility-preserving management. Histopathology established the final diagnosis. Conclusions: This case emphasizes the importance of considering SPAC in the differential diagnosis of complex adnexal masses. Early recognition and intraoperative frozen section can guide conservative surgical strategies, avoiding overtreatment and preserving reproductive potential in young patients.