Matsuda Katsuya, Tateishi Seiko, Akazawa Yuko, Kinoshita Akira, Yoshida Shiko, Morisaki Sachiko, Fukushima Ai, Matsuwaki Takahiro, Yoshiura Koh-Ichiro, Nakashima Masahiro
Departments of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Department of Obstetrics and Gynecology, Japan Community Health Care Organization, Isahaya General Hospital, Isahaya, Japan.
Diagn Pathol. 2016 Oct 22;11(1):101. doi: 10.1186/s13000-016-0554-7.
Mitotically 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.
A 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.
To 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.
卵巢有丝分裂活跃性细胞性纤维瘤（MACF）以相对较高的有丝分裂活性且无严重异型性为特征，是一种相对较新的疾病实体。MACF被归类为良性卵巢肿瘤。然而，由于病例报告数量有限，其临床和病理特征以及最佳治疗方法在很大程度上仍未确定。在此，我们报告一例罕见的MACF病例，该病例在随访期间肿瘤大小迅速增长，并经详细病理检查确诊。
一名44岁的日本女性，1年前发现肌瘤样病变，随访检查发现肿块增大后转诊至我院。磁共振成像显示右盆腔有一个T1等信号和T2高信号肿瘤（直径11厘米）。腹腔镜检查证实存在右卵巢肿瘤，并进行了腹腔镜右附件切除术。肿瘤细胞由密集的梭形成纤维细胞样细胞增殖组成，无明显细胞学异型性。有丝分裂活性指数估计为每10个高倍视野>15个有丝分裂象。网状纤维染色和FOXL2突变分析排除了成人颗粒细胞瘤的可能性，该患者被诊断为卵巢MACF。
据我们所知，我们是首例报告卵巢MACF在随访期间迅速生长的病例。当发现实性卵巢肿块增大时，应考虑MACF作为鉴别诊断。
