Table of Contents
Definition / general | Epidemiology | Sites | Pathophysiology | Clinical features | Laboratory | Radiology description | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Differential diagnosisCite this page: Gupta N. Fibromatosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorfibromatosis.html. Accessed May 29th, 2020.
Definition / general
- First defined by Young and Scully in 1984 as tumorlike ovarian enlargement due to diffuse ovarian fibrosis, caused by nonneoplastic proliferation of undifferentiated ovarian stroma (Int J Gynecol Pathol 1984;3:153)
Epidemiology
- Premenopausal females (mean age 25 years, range 13 - 39 years, Br J Radiol 2012;85:477)
Sites
- Abdominal or extraabdominal
Pathophysiology
- Local tissue injury activates platelets and macrophages, which release growth factors that stimulates fibroblastic proliferation around follicle
- May represent burnt out stage of massive ovarian edema (Surgical Pathology of the Ovaries - pgs. 147-54)
Clinical features
- Menstrual abnormalities, abdominal pain
- Rarely hirsutism or virilization
Laboratory
- Normal: CA125, CEA, CA19-9, AFP
Radiology description
- Ultrasonography: intrapelvic solid tumors including cystic areas
- CT: hyperdense (to myometrium), homogenous, solid and variably enhancing solid ovarian mass
- MRI: Hypointense lobulated ovarian masses (Gynecol Oncol 2004;94:223)
Case reports
- 19 year old woman with bilateral ovarian fibromatosis presenting with ascites and hirsutism (Gynecol Oncol 2004;94:223)
Treatment
- Salpingo-oophorectomy
Clinical images
Images hosted on other servers:
Ovarian fibromatosis
Bilateral heterogeneously echogenic ovarian masses
Slightly hyperattenuating
Poor enhancement of masses
Low signal intensity
Bilateral adnexal masses
Gross description
- Solid ovarian mass 8-14 cm in diameter
- Cut surface is grey-white, solid
Gross images
Images hosted on other servers:
Left ovarian mass
Microscopic (histologic) description
- Fibromatoid proliferation of collagen producing spindle cell with follicles entrapped within the lesion
Differential diagnosis
- Fibroma: well circumscribed
- Fibrothecoma: well circumscribed
- Massive edema: marked edema of stroma surrounding follicles and clusters of luteinized cells
- Stromal hyperplasia: older age, lipid containing cells
