Stromal tumors

Author: Sanjay Logani, M.D. (see Authors page)

Revised: 26 January 2017, last major update June 2010

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed search: adenofibroma uterus

Cite this page: Adenofibroma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusadenofibroma.html. Accessed March 24th, 2017.
Definition / General
  • Uncommon (much less common than adenosarcoma)
  • Usually postmenopausal women
  • Usually arises from endometrium, but may be found in cervix, ovary, round and broad ligaments, pelvic wall
  • Related to papillary adenofibroma, cystadenofibroma, lipoadenofibroma and adenomyomatosis
  • May be extremely difficult to distinguish from low grade adenosarcoma (Am J Surg Pathol 2009;33:278)
  • Some authors recommend classification as adenosarcoma of low malignant potential
Clinical Features
Prognostic Factors
  • Criteria to determine malignant potential is similar to phyllodes tumors
  • Malignant (adenosarcoma) if 2+ stromal mitotic figures / 10 HPF, marked stromal cellularity with periglandular cuffing or significant stromal cell atypia
Case Reports
  • Hysterectomy is usually curative
  • Recurrence is rare and associated with conservative resection
Gross Description
  • Polypoid, broad based; firm, papillary and multicystic; no necrosis
Micro Description
  • Cleft like papillary architecture
  • Comprised of benign glands and benign appearing stroma
  • Surface epithelium often extends deeply into stroma
  • Prominent cystic spaces
  • Stroma is composed of benign appearing fibroblasts or endometrial stromal cells
  • Variable epithelial lining (epithelioid, mucinous, serous)
  • No stromal atypia, no periglandular cuffing and no / rare mitotic figures
Micro Images

Images hosted on other servers:

Various images

Dense fibrous connective tissue and glandular spaces

Differential Diagnosis
  • Adenosarcoma: more common than adenofibroma; periglandular condensation of stroma creating hyper- and hypocellular zones and formation of cambium layer, cellular and mitotically active stroma