Bucella Dario, Limbosch Jean-Frédéric, Buxant Frédéric, Simon Philippe, Fayt Isabelle, Anaf Vincent, Noël Jean-Christophe
Département de Gynécologie, Hôpital Universitaire Erasme, Route de Lennik 808, 1070 Brussels, Belgium.
Obstet Gynecol Int. 2009;2009:803062. doi: 10.1155/2009/803062. Epub 2009 Jan 12.
Background. 10% of ovarian fibromatous tumours typically exhibit increased cellularity, mitotic activity, and less frequently nuclear atypia. Therefore, the classification within the group of fibromatous tumours may represent some difficulties, thus, one or several of these features should appear. Case. We introduce the clinical and pathologic features based on one case of recurrence of a mitotically active cellular ovarian fibroma (MACF) in the pararectal fossa. This recurrence took place six years after primary surgery. Macroscopically, the tumour was firm, fibrous, well delimited, yellow-white without gross necrosis. On microscopic examination, it was composed of a densely cellular proliferation of fibrolastic-like cells with bland nuclear features and arranged in a fascicular pattern. There was no sign of significant atypia or necrosis. Conclusion. Recently, this case is the first report of a recurrence of MACF, following primary surgery with no tumoral rupture or surgical difficulty. The clinical outcome of ovarian cellular fibromas (CFs) and MACFs is typically uneventful. This case, however, strongly suggests maintaining a long-term clinical follow-up even though the principal tumour was surgically treated without tumour rupture or in the absence of adherence or any surgical difficulty.
背景。10%的卵巢纤维瘤样肿瘤通常表现为细胞增多、有丝分裂活性增加,较少见核异型性。因此,纤维瘤样肿瘤组内的分类可能存在一些困难,所以,这些特征中的一项或几项应该出现。病例。我们基于一例直肠旁窝有丝分裂活跃的细胞性卵巢纤维瘤(MACF)复发的病例介绍其临床和病理特征。此次复发发生在初次手术后六年。大体上,肿瘤质地硬、呈纤维性、边界清晰、黄白色,无明显坏死。显微镜检查显示,它由纤维母细胞样细胞密集增殖构成,细胞核特征温和,呈束状排列。没有明显异型性或坏死的迹象。结论。最近,该病例是初次手术后MACF复发的首例报告,术中无肿瘤破裂或手术困难。卵巢细胞性纤维瘤(CFs)和MACF的临床结局通常平稳。然而,该病例强烈提示,即使主要肿瘤在手术治疗时未发生肿瘤破裂、不存在粘连或任何手术困难,也应进行长期临床随访。