Rapid growth of mitotically active cellular fibroma of the ovary: a case report and review of the literature
BackgroundMitotically active cellular fibroma (MACF) of the ovary, characterized by relatively high mitotic activity without severe atypia, represents a relatively new disease entity. MACF is categorized as a benign ovarian tumor. However, due to a limited number of case reports, its clinical and pathological features and optimum management remains largely undetermined. Herein, we report on a rare case of MACF that grew rapidly in size and was diagnosed on detailed pathological examination.Case presentationA 44 year old Japanese woman, who detected a myoma like lesion 1 year earlier, was referred to our hospital when the follow up examination demonstrated that the mass had increased in size. Magnetic resonance imaging revealed a T1 isointense and T2 hyperintense tumor (11 cm in diameter) in the right pelvic cavity. Laparoscopy confirmed the presence of a right ovarian tumor and laparoscopic right adnexectomy was performed. The tumor cells consisted of dense cellular proliferations of spindle fibroblast like cells without significant cytological atypia. The mitotic activity index was estimated at >15 mitotic figures per 10 high power fields. Reticulin staining and FOXL2 mutation analysis excluded the possibility of an adult granulosa cell tumor, and the patient was diagnosed with a MACF of the ovary.ConclusionsTo the best of our knowledge, we are the first to report on a case of rapid growth of a MACF of the ovary during follow up. When an increase in the size of a solid ovarian mass is detected, a MACF should be considered as a differential diagnosis.
Diagnostic Pathology