Difference between revisions of "Ovarian fibroma"

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#redirect [[Ovarian_tumours#Ovarian_fibroma]]
{{ 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]]

Latest revision as of 16:04, 29 November 2015

Ovarian fibroma
Diagnosis in short

Ovarian fibroma. H&E stain.

LM

spindle cells with a central nucleus and no nuclear atypia;

patternless pattern (not fascicular, not herring bone), +/-calcification
LM DDx thecoma, leiomyoma, fibrosarcoma, metastatic metaplastic carcinoma, endometriosis with fibrosis
IHC inhibin -ve
Gross solid white mass, usu. well-circumscribed
Site ovary - see ovarian tumours

Syndromes Meigs syndrome, nevoid basal cell carcinoma syndrome (esp. if calcified)

Prevalence uncommon
Prognosis benign
Clin. DDx other ovarian tumours - esp. solid ones

Ovarian fibroma is a benign ovarian tumour.

General

Gross

Features:

  • Solid white mass, usually well-circumscribed.[4]

Note:

  • Thecoma = yellow solid mass.[4]

Images

www:

Microscopic

Features:[5][6]

  • Spindle cells with central nucleus and no nuclear atypia.
  • Patternless pattern (AKA storiform pattern) - not fascicular, not herring bone.
  • Stainable lipid - minimal or none.[6]

Notes:

  • May be cellular.
  • Mitotic activity minimal.[7]

DDx:

Images

IHC

  • Inhibin -ve (~75%).[6]

Sign out

 OVARIAN MASS ("FIBROMA"), LEFT, EXCISION:
- FIBROMA.
- NEGATIVE FOR MALIGNANCY.

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

References

  1. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1103. ISBN 0-7216-0187-1.
  2. Tytle, T.; Rosin, D. (Sep 1984). "Bilateral calcified ovarian fibromas.". South Med J 77 (9): 1178-80. PMID 6385289.
  3. URL: http://brighamrad.harvard.edu/Cases/bwh/hcache/353/full.html. Accessed on: 4 October 2011.
  4. 4.0 4.1 Rose, Alan G. (2008). Atlas of Gross Pathology with Histologic Correlation (1st ed.). Cambridge University Press. pp. 398. ISBN 978-0521868792.
  5. URL: http://www.pathologyoutlines.com/ovarytumor.html#fibroma. Accessed on: 7 May 2012.
  6. 6.0 6.1 6.2 Roth, LM. (Jul 2006). "Recent advances in the pathology and classification of ovarian sex cord-stromal tumors.". Int J Gynecol Pathol 25 (3): 199-215. doi:10.1097/01.pgp.0000192271.22289.e6. PMID 16810055.
  7. Huang, L.; Liao, LM.; Wang, HY.; Zheng, M. (2010). "Clinicopathologic characteristics and prognostic factors of ovarian fibrosarcoma: the results of a multi-center retrospective study.". BMC Cancer 10: 585. doi:10.1186/1471-2407-10-585. PMID 20979607.
  8. Rajabi, P.; Hani, M.; Bagheri, M.; Mirzadeh, F. (2014). "Large ovarian leiomyoma in young woman.". Adv Biomed Res 3: 88. doi:10.4103/2277-9175.128001. PMID 24761396.