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Ovarian Mucinous Cystadenoma After Ovarian Graft. BACKGROUND: Freezing strips of ovarian cortex before chemotherapy followed by transplantation is an experimental method to preserve fertility for reproductive-aged women with cancer. We report a case of a cancer patient who developed a mucinous cystadenoma in a grafted piece of ovarian cortex. CASE: A 32-year-old woman with a Ewing sarcoma had ovarian cryopreservation using cortical strip freezing before receiving chemotherapy. Five years later she had no ovarian function, and the strips were thawed and grafted back onto the ovary. She spontaneously became pregnant 1 year after this procedure and delivered a healthy neonate near term. During the cesarean delivery, a 5×3-cm cyst was removed from the graft. On pathologic evaluation, it was determined to be a mucinous cystadenoma. CONCLUSION: Ovarian pathology can develop in previously frozen ovarian cortex tissue after transplantation back onto the ovary. This suggests that routine gynecologic surveillance remains important for these women.