Clinical, radiological, and pathological features of mitotically active cellular fibroma of ovary: A review of cases with literature review

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-09-01 DOI:10.1016/j.tjog.2024.04.016
Eun Taeg Kim , Yong Jung Song , Ki Yeon Park , Chung Su Hwang , Nam Kyung Lee , Hyun-Jin Roh , Dong Soo Suh , Ki Hung Kim
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Abstract

Objective

Mitotically active cellular fibroma (MACF) of the ovary, characterized by relatively high mitotic activity without severe atypia, was first described in the WHO classification in 2014. However, due to its rarity, the clinicopathological characteristics of ovarian MACF have not been established. This study was performed to describe the clinical, radiological, and pathological features of MACF by analyzing 11 cases of ovarian MACF.

Materials and methods

Between 2015 and 2022, 11 patients with ovarian MACFs underwent surgical treatment at our institution. Clinicopathologic data of the patients were retrospectively reviewed from their medical records.

Results

Median patient age was 53.7 years (range 21–77 years), and median tumor diameter was 7.8 cm (range 4.3–14.0 cm). Preoperative CA125 was elevated in 4 cases. Four of the eleven patients had abdominal pain, and two presented with vulvar pain or a palpable abdominal mass, respectively. Preoperative radiological impressions included fibroma, fibrothecoma, stromal tumor, and cystadenocarcinoma. A laparoscopic approach was adopted in 7 cases (64%). Intraoperative frozen section was performed in 5 patients, and all demonstrated the presence of a benign, fibromatous stromal tumor. Three patients underwent fertility-sparing surgery, including laparoscopic ovarian cystectomy and unilateral salpingo-oophorectomy. Median follow-up was 37.7 months (range 2–84 months), and no patient experienced disease relapse or died of their disease.

Conclusion

This study shows that ovarian MACF has a benign clinical course. Fertility-sparing surgery provides a safe therapeutic option for MACF, which can be managed safely by laparoscopy. Imaging findings and final pathological diagnosis were not well matched. Intraoperative frozen section is important for determining surgical extent in mitotically active cellular fibroma of the ovary.

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卵巢有丝分裂活跃细胞纤维瘤的临床、放射学和病理学特征:病例回顾与文献综述
目的卵巢有丝分裂活跃细胞纤维瘤(MACF)的特点是有丝分裂活性相对较高,但无严重不典型性,于2014年首次在世界卫生组织的分类中被描述。然而,由于其罕见性,卵巢MACF的临床病理特征尚未确定。本研究通过分析11例卵巢MACF,描述MACF的临床、放射学和病理学特征。材料与方法2015年至2022年间,11例卵巢MACF患者在我院接受了手术治疗。结果患者平均年龄为 53.7 岁(21-77 岁),中位肿瘤直径为 7.8 厘米(4.3-14.0 厘米)。4例患者术前CA125升高。11 名患者中有 4 人腹痛,2 人分别伴有外阴疼痛或腹部可触及肿块。术前影像学表现包括纤维瘤、纤维肉瘤、间质瘤和囊腺癌。7例(64%)采用腹腔镜手术。5 例患者进行了术中冰冻切片检查,结果均显示存在良性纤维基质瘤。三名患者接受了保胎手术,包括腹腔镜卵巢囊肿切除术和单侧输卵管切除术。中位随访时间为 37.7 个月(2-84 个月),没有患者复发或死亡。这项研究表明,卵巢澳门巴黎人娱乐官网的临床过程是良性的,保胎手术为卵巢澳门巴黎人娱乐官网提供了一种安全的治疗方案,腹腔镜手术可以安全地治疗卵巢澳门巴黎人娱乐官网。影像学检查结果与最终病理诊断并不完全吻合。术中冰冻切片对于确定有丝分裂活跃的卵巢细胞纤维瘤的手术范围非常重要。
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来源期刊
CiteScore
3.60
自引率
23.80%
发文量
207
审稿时长
4-8 weeks
期刊介绍: Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.
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