Background: The occurrence of extramedullary plasmacytoma (EMP) in the ovaries is rare. Here, we describe the clinical, pathological and radiological presentations of ovarian plasmacytomas to improve the differential diagnosis of this disease. Also, the reasons for misdiagnosis, clinical manifestations and radiological features were discussed through a literature review.

Methods: A 54-year-old woman was suspected to have EMP upon routine ultrasound examination and was subsequently diagnosed using pathological examination of the left ovarian mass. The radiological features of this case included (1) a solitary soft-tissue mass in the left ovary with clear boundaries; (2) a homogeneous mass with medium-density without necrosis, which was homogeneously enhanced after contrast medium injection; and (3) magnetic resonance imaging showing a homogeneous lesion with isointense signals on T1- and T2-weighted imaging, restricted diffusion on diffusion-weighted imaging, and a low apparent diffusion coefficient value of approximately 0.72×10-3 mm2/s, which was significantly and homogeneously enhanced after contrast medium injection with a rapid rise-slow decay type, and with thickened vascular shadows around the lesion.

Conclusions: EMP in the ovary is rare and only a few cases have been reported. We reviewed EMP-related literature and the summarized the clinical manifestations, radiological features and treatment strategies of this disease to help the diagnosis and management. Application of second-line drugs might be a viable strategy to improve the survival rate of patients and to prevent the progression to a certain extent.