Mitotically active cellular fibroma of the ovary: a rare case and review of literature

Abstract Mitotically active cellular fibroma (MACF) is a category of fibromatous tumours of the ovary described in the WHO classification of tumours of female reproductive organs. The case of a 54-year-old female who presented with lower limb swelling due to deep vein thrombosis (DVT) is reported. On examination, she had a 5 x 8 cm fixed pelvic mass. She underwent optimal cytoreductive surgery. Grossly the tumour, which was found to occupy the left pelvic space, was hard and irregular in shape and was adherent to the surrounding structures. Histopathology revealed collagen-producing spindle cells showing mitotic activity of 6–8/10 HPF with minimal nuclear atypia and Ki 67 labelling index of 10%. A final diagnosis of MACF was made. In view of sparse evidence regarding its management and due to residual tumour (< 1 cm), she received adjuvant radiotherapy. She has remained disease free over a period of two years.