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El cistoadenofibroma ovárico es un tumor benigno poco frecuente y se caracteriza por un patrón bifásico compuesto por componentes epiteliales y estromales; actualmente se desconocen los factores de riesgo asociados, aunque las mujeres obesas y las menopáusicas que consumen terapia de reemplazo hormonal tienen un mayor riesgo. Se presentó una adolescente de 17 años de edad, evaluada en consulta externa dos años antes, por un quiste de ovario izquierdo; recibió tratamiento hormonal sin resultados satisfactorios. Se le practicaron exámenes de analítica sanguínea y estudios de imagen. Con la administración de anestesia regional epidural continua se realizó anexectomía izquierda, se confirmó mediante estudio histológico, un cistoadenofibroma seroso de ovario. El objetivo del tratamiento en estas pacientes es la remoción quirúrgica completa de la lesión ante el riesgo de malignización; este tratamiento quirúrgico fue fundamental y la evolución fue favorable, tuvo un periodo de recuperación de corta duración y muy positivo.
Ovarian cystadenofibroma is a rare benign tumour characterized by a biphasic pattern made up of epithelial and stromal components; associated risk factors are currently unknown, although obese and menopausal women taking hormone replacement therapy are at increased risk. We present a 17-year-old female adolescent who was evaluated in an outpatient clinic two years earlier due to a left ovarian cyst. She received hormonal treatment without satisfactory results. She underwent blood analysis tests and imaging studies. Left adnexectomy was performed with the administration of continuous epidural regional anesthesia, and a serous ovarian cystadenofibroma was confirmed by histological study. The goal of treatment in these patients is the complete surgical removal of the lesion given the risk of malignancy; this surgical treatment was fundamental and the evolution was favourable. She had a short and very positive recovery period.
Subject(s)
Ovary , CystadenofibromaABSTRACT
ANTECEDENTES: El cistoadenofibroma seroso de ovario es una neoplasia epitelial benigna, relativamente infrecuente, de crecimiento lento y de causa desconocida. El diagnóstico preoperatorio es complejo debido a la ausencia de síntomas y signos específicos que permitan descartar la malignidad. OBJETIVO: Analizar retrospectivamente las características clínicas, radiológicas, histopatológicas, y la atención médica de las pacientes. MATERIALES Y MÉTODOS: Análisis retrospectivo y descriptivo de pacientes con diagnóstico histopatológico de cistoadenofibroma seroso de ovario atendidas en el Hospital General de Albacete entre los años 2010 a 2022. RESULTADOS: Se analizaron 635 piezas quirúrgicas, de las que el 57.74% correspondieron a neoplasias serosas benignas, el 17.41% a neoplasias serosas fronterizas y un 24.85% a neoplasias serosas malignas. Se identificaron 20 casos de pacientes con diagnóstico de cistoadenofibroma seroso de ovario. La edad media de esas pacientes fue de 47 años, con límites de 9 y 74 años. Un caso se asoció con un tumor proliferativo seroso atípico contralateral. El tratamiento fue quirúrgico y no se identificaron recurrencias en ninguno de los casos. CONCLUSIONES: El cistoadenofibroma seroso suele manifestarse como un quiste ovárico complejo, con componentes sólidos-quísticos y tabiques irregulares; por esto a menudo se diagnostica erróneamente como tumor maligno antes de la intervención. La biopsia por congelación ayuda a confirmar su naturaleza benigna y evita una cirugía extensa innecesaria. El tratamiento consiste, principalmente, en la extirpación quirúrgica del quiste con o sin ooforectomía. El pronóstico suele ser excelente.
Abstract BACKGROUND: Serous ovarian cystoadenofibroma is a relatively rare, slow-growing, benign epithelial neoplasm of unknown cause. Preoperative diagnosis is complex due to the absence of specific symptoms and signs to rule out malignancy. OBJECTIVE: To retrospectively analyze the clinical, radiologic, histopathologic features, and medical care of the patients. MATERIALS AND METHODS: Retrospective and descriptive analysis of patients with histopathological diagnosis of ovarian serous cystoadenofibroma attended at the General Hospital of Albacete between the years 2010 to 2022. RESULTS: 635 surgical specimens were analyzed, of which 57.74% corresponded to benign serous neoplasms, 17.41% to borderline serous neoplasms and 24.85% to malignant serous neoplasms. Twenty cases of patients with a diagnosis of ovarian serous cystoadenofibroma were identified. The mean age of these patients was 47 years, with limits of 9 and 74 years. One case was associated with a contralateral atypical serous proliferative atypical tumor. Treatment was surgical and no recurrences were identified in any of the cases. CONCLUSIONS: Serous cystoadenofibroma usually manifests as a complex ovarian cyst, with solid-cystic components and irregular septa; this is why it is often misdiagnosed as a malignant tumor before surgery. Freeze biopsy helps to confirm its benign nature and avoids unnecessary extensive surgery. Treatment consists mainly of surgical removal of the cyst with or without oophorectomy. The prognosis is usually excellent.
ABSTRACT
Mucinous cystadenofibroma of ovary is a rare benign tumor. A 55-year old post-hysterectomy woman with ovarian mucinous cystadenofibroma, diagnosed as benign cystic lesion prior to surgery. Patient successfully underwent excision of cyst.
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Resumen ANTECEDENTES: Entre las neoplasias epiteliales ováricas, los cistoadenomas son los más comunes y casi todos son de buen pronóstico. Pueden aparecer a cualquier edad, aunque gran parte surgen entre los 40 y 60 años. CASO CLÍNICO: Paciente de 63 años, con necrosis seca distal en el antepié derecho, con un cistoadenofibroma seroso en el ovario izquierdo que ocluía una arteria iliaca común y causó una trombosis distal que requirió intervención quirúrgica y amputación transmetatarsiana derecha. CONCLUSIÓN: El diagnóstico y tratamiento quirúrgico oportuno son decisivos para evitar la extensión de la necrosis y lograr la conservación de la mayor parte de la extremidad afectada.
Abstract BACKGROUND: Among ovarian epithelial neoplasms, cystadenomas are the most common and almost all of them have a good prognosis. They can appear at any age, although most arise between 40 and 60 years of age. CLINICAL CASE: A 63-year-old patient with distal dry necrosis in the right forefoot, with a serous cystadenofibroma in the left ovary that occluded a common iliac artery and caused a distal thrombosis that required surgical intervention and right transmetatarsal amputation. CONCLUSION: Timely diagnosis and surgical treatment are decisive to avoid the extension of necrosis and to achieve the preservation of most of the affected limb.
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Ovarian cystadenofibromas is a benign ovarian tumor that typically affects women in their fifth decade. Its risk factors remain unknown. This case study report 3 cases of ovarian cystadenofibromas treated in our department. The patients are aged 21, 28 and 50 years-old. The clinical pictures were polymorphic but the pelvic ultrasound of the case patients showed cystic ovarian masses suspected of malignancy. Two patients underwent laparoscopic ovarian cystectomy, and the third one, aged 50, underwent laparoscopic adnexectomy. The anatomopathological study showed benign ovarian cystadenofibromas. The operating follow ups were simple. It represents a relatively rare tumor whose macroscopic aspect evokes ovarian cancer wrongly leading to an aggressive surgical attitude.
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@#<p>Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by failure of embryologic growth of the mullerian ducts resulting to agenesis or hypoplasia of the uterus and upper part of the vagina while both ovaries and fallopian tubes are normal. Various associated malformation with MRKH syndrome are noted in literature, with a renal system anomaly as the most common. However, adnexal tumors in MRKH syndome are rare. To date there have been no reported cases of fallopian tube tumors in patients diagnosed with MRKH. This paper presents a case of an 18 year old nulligravida who presented with primary amenorrhea secondary to MRKH sydnrome, with an associated Papiliary Serous Cystadenofibroma of the right fallopian tube Management of the case as well as review of related literature are presented. </p>
Subject(s)
CystadenofibromaABSTRACT
Brenner tumor, and cystadeno fibroma of ovary are rare varieties of ovarian tumor, characterized by presence of solid components. There are very rare instances where both Brenner tumor and cystadenofibroma coexist in a single patient. A 48-year P1L1, postmenopusal woman presented at Guru hospital, Madurai, with chief complaints of on and off postmenopausal bleeding for 6 months. On ultrasonography there were two simple cysts of ovary measuring 6x 6 cm on left side and 4x4 cm on right side. She was managed with total laparoscopic hysterectomy and bilateral salpingoophorectomy. Intraoperatively there was a right ovarian mass of 6x6 cm size and a left ovarian mass of 4x4 cm size. Left ovarian mass reported as benign cystadenofibroma while the right ovarian mass was reported to be brenners tumor on histopathology. As the preoperative imaging are not completely relied for diagnosing these tumors, awareness of the surgeons of these entities is particularly important. The prognosis of both of these tumors is excellent with suitable treatment. They have a very low recurrence risk on compete removal through surgery.
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The aim of this study is to report a rare case of ovarian cystadenofibroma with even scarcely observed mucinous type histopathological variant and to discuss the modalities which can contribute to prevent misdiagnosing it as a malignant tumor that may inappropriately lead to aggressive surgical interventions. A 40-year-old female presented with pain in lower abdomen and dysmenorrhea of 3 months duration and a large right adnexal mass which had all the features suggestive of malignancy in pre-operative investigations and even on gross overview and cut section. On the contrary histopathology reports confirmed its benign nature and reported it as mucinous cystadenofibroma. Role of Preoperative MRI and intraoperative frozen section cannot be overemphasized in distinguishing ovarian cystadenofibroma from malignant tumors, which can avoid an unnecessary extensive surgery.
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Objective To investigate the CT features of ovarian cystadenofibroma(CFA)and to improve the diagnostic accuracy. Methods The clinical data and CT images of 7 patients with ovarian CFA were retrospectively analyzed.All cases underwent non-enhanced and contrast-enhanced CT scan.Results Ovarian lesions were unilateral in 5 cases,bilateral in 2 cases and totally 9 lesions were found.6 lesions were cystic,2 lesions were mainly solid and 1 lesion was mixed components.The maximum diameter of lesions ranged from 4.7-21.5 cm with an average of 8.2 cm.Lesions had smooth margins,and solid portions had different size vesicles. Cyst walls or septa showed various degree of thickening with calcification in 1 lesion and mural nodules in 5 lesions,and a small vesicle was visualized in only 1 of the mural nodules.Cystic portions appeared as fluid density without enhancement.Solid portions,thickened cyst walls and septa appeared as slight enhancement or no enhancement.No regional lymph node metastasis was found,no ascites or peritoneal implants as well.Conclusion Ovarian CFA has some characteristic of CT findings that may improve clinical diagnosis and differential diagnosis.
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Serous papillary cystadenofibromas (SPCAFs) of the fallopian tube are very rare benign tumors of the female genital tract. They are usually asymptomatic and are found incidentally. Until now, only 18 cases of this tumor have been reported in the world literature. We report a case of SPCAF of the left fallopian tube in a 30‑year‑old female who presented with a large abdominal mass and pain. On computed tomography, a diagnosis of ovarian neoplasm was given. However, during surgery the tumor was found to arise from the fallopian tube and was treated with tubal cystectomy with sparing of the ovary. We present this unique case on account of its rarity, unusual presentation, and huge size along with a short review of literature.
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Most clear cell tumors of the ovaries are carcinomas; benign and borderline clear cell tumors are uncommon. We describe here a 52-year-old postmenopausal woman with an ovarian clear cell cystadenofibroma that was misdiagnosed before surgery as a borderline malignant cystic mass of the ovary. The ovarian mass had cystic and solid components. Histological examination revealed widely spaced simple glands embedded in a dense fibrous stroma. The glands were lined with one to two layers of hobnail cells, flattened cells, or cells with abundant clear cytoplasm. The patient successfully underwent a left oophoro-salpingectomy.
Subject(s)
Female , Humans , Middle Aged , Cystadenofibroma , Cytoplasm , OvaryABSTRACT
OBJECTIVE: We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. MATERIALS AND METHODS: The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. RESULTS: All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2-dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. CONCLUSION: Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.
Subject(s)
Middle Aged , Humans , Female , Adult , Sensitivity and Specificity , Reproducibility of Results , Ovarian Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Leiomyoma/diagnosis , Image Enhancement/methods , Diagnosis, Differential , Cystadenoma/diagnosis , Adenofibroma/diagnosisABSTRACT
Familial adenomatous polyposis (FAP) is a hereditary disease characterized by the appearance of numerous polyps in the large bowel with a high potential for malignant transformation unless untreated. A variety of extracolonic manifestations were reported such as osteoma, epidermoid cyst, desmoid tumor, gastroduodenal polyps, small bowel tumor, congenital hypertrophy of the retinal pigment epithelium, hepatobiliary tumor, thyroid tumor, and tumor of the central nervous system. However, the ovarian involvement of FAP as an extracolonic manifestation was very rare and there have been only few reports. We experienced a rare case of ovarian cystadenofibroma in a patient with FAP as an extracolonic manifestation. We also found colon cancer with multiple hepatic metastasis initially manifested as intestinal obstruction in the same patient. Surgical treatment and subsequent chemotherapy for colon cancer and intraoperative radiofrequency ablation of hepatic metastasis were performed.
Subject(s)
Humans , Adenomatous Polyposis Coli , Catheter Ablation , Central Nervous System , Colonic Neoplasms , Cystadenofibroma , Drug Therapy , Epidermal Cyst , Fibromatosis, Aggressive , Genetic Diseases, Inborn , Hypertrophy , Intestinal Obstruction , Neoplasm Metastasis , Osteoma , Polyps , Retinal Pigment Epithelium , Thyroid GlandABSTRACT
Objective To investigate the morbidity, clinical characteristics, diagnosis, the pathological classification, character and special behaviour of transformation and the tendency of development of ovarian adenofibroma and cystadenofibroma, so as to provide information for clinical work. Methods 7 patients of ovarian adenofibroma and cystadenofibroma were retrospectively analysed on their onset age, clinical manifestations, ultrasonographic findings, pelvic examination and postsurgical pathology. Results All the seven tumors were serous. The ultrasonography revealed a cystic mass in the overy or near the overy, with clear boundary, and regular in shape. Three tumors were papillary (with rich signal of circulation in the papillary wall in two cases). In one case there was rich circulatory signal in the wall of the cyst. Three tumors had neither papilla on the wall of the cyst, nor blood signal. Pathological examination showed that 4 tumors were benign, and three were borderline. Conclusion The tumor is more prevalent in women of childbearing age. Unilateral tumor is more common than bilateral. The tumor is mainly serous, most of them are benign, and malignant tumors are rare. Ultrasonograply may be helpful to defining the nature and differentiation of the tumor