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# | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Ovarian_fibroma_-_high_mag.jpg | |||
| Width = | |||
| Caption = Ovarian fibroma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = [[spindle cell]]s with a central nucleus and no nuclear atypia; | |||
patternless pattern (not fascicular, not [[herring bone]]), +/-calcification | |||
| Subtypes = | |||
| LMDDx = [[thecoma]], [[leiomyoma]], [[fibrosarcoma]], metastatic [[metaplastic carcinoma]], [[endometriosis]] with fibrosis | |||
| Stains = | |||
| IHC = inhibin -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = solid white mass, usu. well-circumscribed | |||
| Grossing = | |||
| Site = [[ovary]] - see ''[[ovarian tumours]]'' | |||
| Assdx = | |||
| Syndromes = [[Meigs syndrome]], [[nevoid basal cell carcinoma syndrome]] (esp. if calcified) | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = other ovarian tumours - esp. solid ones | |||
| Tx = | |||
}} | |||
'''Ovarian fibroma''' is a benign [[ovarian tumour]]. | |||
==General== | |||
*May be a part of: | |||
*#[[Meigs syndrome]] (mnemonic ''FAR'': fibroma, [[ascites]], right pleural [[effusion]]). | |||
*#[[Nevoid basal cell carcinoma syndrome]] (NBCCS), AKA ''Gorlin syndrome''.<ref name=Ref_PBoD1103>{{Ref PBoD |1103}}</ref> | |||
*#*In NBCCS classically - calcified and bilateral.<ref name=pmid6385289>{{Cite journal | last1 = Tytle | first1 = T. | last2 = Rosin | first2 = D. | title = Bilateral calcified ovarian fibromas. | journal = South Med J | volume = 77 | issue = 9 | pages = 1178-80 | month = Sep | year = 1984 | doi = | PMID = 6385289 }}</ref> | |||
*Very rarely transform to [[adult fibrosarcoma|fibrosarcoma]] <1%.<ref>URL: [http://brighamrad.harvard.edu/Cases/bwh/hcache/353/full.html http://brighamrad.harvard.edu/Cases/bwh/hcache/353/full.html]. Accessed on: 4 October 2011.</ref> | |||
==Gross== | |||
Features: | |||
*Solid white mass, usually well-circumscribed.<ref name=Ref_AoGP398>{{Ref AoGP|398}}</ref> | |||
Note: | |||
*Thecoma = yellow solid mass.<ref name=Ref_AoGP398>{{Ref AoGP|398}}</ref> | |||
===Images=== | |||
www: | |||
*[http://www.flickr.com/photos/78147607@N00/2871451742 Ovarian fibroma (flickr.com/euthman)]. | |||
*[http://www.wikidoc.org/index.php/File:Ovarian_Fibroma.jpg Ovarian fibroma (wikidoc.org)]. | |||
==Microscopic== | |||
Features:<ref>URL: [http://www.pathologyoutlines.com/ovarytumor.html#fibroma http://www.pathologyoutlines.com/ovarytumor.html#fibroma]. Accessed on: 7 May 2012.</ref><ref name=pmid16810055>{{Cite journal | last1 = Roth | first1 = LM. | title = Recent advances in the pathology and classification of ovarian sex cord-stromal tumors. | journal = Int J Gynecol Pathol | volume = 25 | issue = 3 | pages = 199-215 | month = Jul | year = 2006 | doi = 10.1097/01.pgp.0000192271.22289.e6 | PMID = 16810055 }}</ref> | |||
*[[Spindle cell]]s with central nucleus and no nuclear atypia. | |||
*Patternless pattern ([[AKA]] storiform pattern) - not fascicular, not herring bone. | |||
*Stainable lipid - minimal or none.<ref name=pmid16810055/> | |||
Notes: | |||
*May be cellular. | |||
*Mitotic activity minimal.<ref name=pmid20979607>{{Cite journal | last1 = Huang | first1 = L. | last2 = Liao | first2 = LM. | last3 = Wang | first3 = HY. | last4 = Zheng | first4 = M. | title = Clinicopathologic characteristics and prognostic factors of ovarian fibrosarcoma: the results of a multi-center retrospective study. | journal = BMC Cancer | volume = 10 | issue = | pages = 585 | month = | year = 2010 | doi = 10.1186/1471-2407-10-585 | PMID = 20979607 }}</ref> | |||
DDx: | |||
*[[Thecoma]] - lipid. | |||
*[[Leiomyoma]] - fascicular architecture, rare in the ovary.<ref name=pmid24761396>{{Cite journal | last1 = Rajabi | first1 = P. | last2 = Hani | first2 = M. | last3 = Bagheri | first3 = M. | last4 = Mirzadeh | first4 = F. | title = Large ovarian leiomyoma in young woman. | journal = Adv Biomed Res | volume = 3 | issue = | pages = 88 | month = | year = 2014 | doi = 10.4103/2277-9175.128001 | PMID = 24761396 }}</ref> | |||
*[[Fibrosarcoma]] - nuclear atypia, classically herring bone pattern, very rare. | |||
*Metastatic [[metaplastic carcinoma]] - nuclear atypia, rare. | |||
*[[Endometriosis]] with extensive fibrosis. | |||
===Images=== | |||
<gallery> | |||
Image:Ovarian_fibroma_-_intermed_mag.jpg | Ovarian fibroma - intermed mag. (WC) | |||
Image:Ovarian_fibroma_-_high_mag.jpg | Ovarian fibroma - high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
*Inhibin -ve (~75%).<ref name=pmid16810055/> | |||
==Sign out== | |||
<pre> | |||
OVARIAN MASS ("FIBROMA"), LEFT, EXCISION: | |||
- FIBROMA. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show spindle cells in a patternless pattern. There is no appreciable nuclear atypia. No mitotic activity is apparent. No necrosis is identified. No calcifications are seen. A small amount of benign ovarian parenchyma is present at the edge of the lesion. | |||
==See also== | |||
*[[Ovarian tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Ovarian tumours]] |
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