García Jiménez Angel, Castellví Josep, Pérez Benavente Assumpció, Díaz de Corcuera Frutos Isabela, Ramón Y Cajal Santiago
Department of Pathology, University Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
Case Rep Med. 2009;2009:802817. doi: 10.1155/2009/802817. Epub 2010 Feb 7.
Primary ovarian fibrosarcomas are very uncommon neoplasms. Since the diagnostic criteria were established in 1981, less than one hundred cases have been reported. This diagnosis can be difficult to establish and other similar appearing mesenchymal processes must be ruled out. In every case this diagnosis is under consideration. Multiple sections of the specimen and immunohistochemical stains will be necessary to support this diagnosis. The difficulty of recognition in frozen section in the majority of the situations implies that the diagnosis should be deferred to the definitive study of the permanent sections with immunohistochemical studies. There exists a histological resemblance between a primary ovarian fibrosarcoma and actively mitotic fibroma. In some cases, it can be impossible to separate exactly these two entities. We report a well-differentiated ovarian fibrosarcoma, with less than 1-2 mitosis x10 HPF and low-grade cytological atypia, similar to active mitotic fibromas, developing liver metastasis one year later. Despite having distant metastasis, some cases with long survival rates have been reported in patients who received chemotherapy after surgery; so that the adjuvant chemotherapy should be considered, especially in young females.
原发性卵巢纤维肉瘤是非常罕见的肿瘤。自1981年确立诊断标准以来，报告的病例不到100例。这种诊断可能很难确立，必须排除其他外观相似的间充质病变。在每一个考虑这种诊断的病例中，都需要对标本进行多个切片并进行免疫组化染色以支持该诊断。在大多数情况下，冰冻切片难以识别，这意味着诊断应推迟到对永久切片进行免疫组化的最终研究。原发性卵巢纤维肉瘤与活跃有丝分裂的纤维瘤在组织学上有相似之处。在某些情况下，可能无法准确区分这两种病变。我们报告一例高分化卵巢纤维肉瘤，每10个高倍视野有丝分裂少于1 - 2个，细胞学异型性低，类似于活跃有丝分裂的纤维瘤，1年后发生肝转移。尽管有远处转移，但有报道称一些患者术后接受化疗后生存率较长；因此，应考虑辅助化疗，尤其是年轻女性患者。
