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LETTER TO THE EDITOR
Year : 2014  |  Volume : 51  |  Issue : 4  |  Page : 505
 

Fibromatosis of the ovary


Department of Pathology, I. G. M. C. Shimla, Himachala Pradesh, India

Date of Web Publication1-Feb-2016

Correspondence Address:
Dr. S Asotra
Department of Pathology, I. G. M. C. Shimla, Himachala Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.175335

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How to cite this article:
Asotra S, Gupta N. Fibromatosis of the ovary. Indian J Cancer 2014;51:505

How to cite this URL:
Asotra S, Gupta N. Fibromatosis of the ovary. Indian J Cancer [serial online] 2014 [cited 2019 Dec 8];51:505. Available from: http://www.indianjcancer.com/text.asp?2014/51/4/505/175335


Sir,

Ovarian fibromatosis characterized by diffuse ovarian fibrosis is a rarer lesion that differs from other pelvic fibrotic process such as fibroma, Brenner tumor, massive edema, and Krukenberg's tumor.

A 27-year-old unmarried female presented with history of pain in lower abdomen and excessive bleeding during menstruation for 5 years.

Exploratory laparotomy was done. There was about 50cc of free fluid in the peritoneal cavity. Bilateral tubes were grossly normal. Uterus was grossly enlarged to 10 weeks size.

Right ovary was grossly enlarged measuring 7 × 5 × 2 cm. The surface was smooth, firm in consistency, and at places solid and pearly white in color.

We received two soft tissue pieces measuring 3 × 2 × 1 cm and 4 × 2 × 2 cm; outer surface smooth and pearly white (appear to be part of ovary).

M/E showed fibromatoid proliferation of the spindle-shaped cells typically surrounding the normal follicular structure of the ovary. The superficial cortex is predominantly thickened and shows acellular bands of dense collagen. In addition, focal areas of stromal edema and uninvolved stroma are also seen. The stroma shows focal collection of chronic inflammatory cells infiltrate [Figure 1]. Final diagnosis of fibromatosis ovary was made.
Figure 1: Photomicrograph showing diffuse fibrous proliferation surrounding cystic follicle H and E, ×400

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Ovarian fibromatosis is a rare benign disorder first described by Young and Scully in young patients (mean age, 25 years) who present with menstrual abnormalities, abdominal and pelvic pain, and occasionally hirsutism or virilization. Ovarian fibromatosis is closely related to ovarian edema, fibromas, Brenner, and Krukenberg tumor.[1],[2]

In fibroma, the abnormal tissue largely effaces the underlying normal structure. Fibromatosis surrounds rather than effaces the underlying normal ovarian structures in contrast to massive edema; however, it has a firm, white fibrous character simulating a solid fibroma rather than an edematous fibroma.[3] Occasionally, one sees edema in a lesion that is predominantly fibromatosis or some fibromatosis areas in a lesion that consist predominantly of massive edema, suggesting that at least in some cases, there may be a relation between these two non-neoplastic lesion.[4]

The case highlights the importance of recognizing fibromatosis of the ovary as distinct entity as it is a benign condition affecting young females and can be confused with ovarian neoplasm.[5] Because of the benign nature of the ovarian fibromatosis and its occurrence in young women, correct pretreatment diagnosis is crucial to determine a laparoscopic approach and to allow conservative treatment.

 
  References Top

1.
Young RH, Scully RE. Fibromatosis, a massive edema of the ovary, possibly related entities: A report of 14 cases of fibromatosis and 11 cases of massive edema. Int J Gynecol Pathol1984;3:153-78.  Back to cited text no. 1
    
2.
Bazot M, Salem C, Cortez A, Antoine JM, Daraï E. Imaging of ovarian fibromatosis. AJR Am J Roentgenol 2003;180:1288-90.  Back to cited text no. 2
    
3.
Kanhere S, Ramani P, Krishnaswami. Massive edema and fibromatosis of ovary-A report of three cases Indian J Pathol Microbiol 1994;37 Suppl: S29-30.  Back to cited text no. 3
    
4.
Roche WR, du Boulay CE.A case of ovarian fibromatosis with disseminated intra-abdominal fibromatosis. Histopathology1989;14:101-7.  Back to cited text no. 4
    
5.
Mohan H, Mohan P, Bal A, Tahlan A. Massive ovarian edema: Report of two cases. Arch Gynecol Obstet 2004;270:199-200.  Back to cited text no. 5
    


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