Cima alla genovese, also known as la cima ripiena (“stuffed cima”), was, like trofie, created out of scarcity, utilizing parts that would have otherwise been thrown away. It originated as a peasant dish, and can be traced back to the 900s CE. In these times meat was a luxury, and this dish does its best to make use of traditionally discarded parts of the cow.
The outer “shell” or layer of cima is a calf's stomach, cut and sewn to form a pocket. It is stuffed with sweetbreads (white, spongy glands sourced from different parts of the calf), brains, testicles, udders and fragments of back, all of the finely chopped. Also added are eggs, garlic, dried mushrooms, butter, pine nuts, parmigiano reggiano, marjoram, green peas, and spices (nutmeg and garlic). Nowadays some people opt to replace the testicles and back with pork. As with many other Ligurian specialties, marjoram is the key ingredient, giving this delicate, difficult-to-prepare dish its signature flavor. The stuffed cima is wrapped in a linen cloth, and then submerged in a pot of vegetable broth, where it is boiled. If it is not sewn properly, and if careful attention is not paid to boiling the sewn-up cima, it may burst, ruining it. It is served cold, usually with pesto for spreading or dipping.