RT Journal Article SR Electronic T1 Primary ovarian synovial sarcoma JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e244756 DO 10.1136/bcr-2021-244756 VO 14 IS 11 A1 Muhammad Amin ur Rahman A1 Khalid Al Wadi A1 Al Nuqaydan A1 Raghad Tallab YR 2021 UL http://casereports.bmj.com/content/14/11/e244756.abstract AB Synovial sarcoma (SS) has a rare occurrence in the female genital tract. Only three prior reports of primary ovarian sarcoma could be retrieved after a thorough literature review. We are reporting a case of primary ovarian SS in a young woman. The tumour showed monophasic spindle cell morphology, and there was a wide list of differential diagnosis to consider. We confirmed the diagnosis by cytogenetics Flourescent Insitu Hybridisation (FISH) technique to identify the classical translocation. The diagnosis of this disease can be challenging especially if the tumour is of monophasic type. Morphology and immunohistochemistry are not enough to confirm the diagnosis in many cases. A confirmatory molecular pathology test is paramount. We have discussed the differential diagnosis of spindle cell tumours in ovary. We suggest that SS should be in the differential diagnoses when facing any atypical spindle cell tumour in the ovary. Molecular pathology techniques can help to confirm the diagnosis.