Mitotically Active Cellular Fibroma of the Ovary: A Case Report

Ovarian fibromas are benign sex cord stromal tumors composed of fibroblastic cells within a collagenous stroma. Fibromas are composed of spindled, ovoid to round cells and collagenous stroma. There are three types of benign fibromas: Fibroma with minor sex cord elements, cellular fibroma and mitotically active cellular fibroma. Fibromas are most common ovarian stromal tumors and encompasses approximately 4% of all ovarian tumors. Cellular fibromas represent approximately 10% of all ovarian fibromas. According to published studies median age of patients with ovarian fibroma is 48 years and are uncommon before 30. The potential of mitotically active cellular fibromas for reccurence and malignant transformation is low (approximately 1%) but possible. So, diagnosis od MACF is important in order to avoid misdiagnosis with ovarian fibrosarcomas and to avoid unnecessary overtreatment. Also, because of low but possible malignant potential in case of MACF, long term follow-up should be recommended. We report a case of mitotically active cellular fibroma in a 68 year old woman with previous vaginal hysterectomy without adnexectomy who applied to our clinic with mild pelvic pain and discomfort. Our intention is to point out its rarity among ovarian tumors and need for long term follow-up, because of its low but possible potential for reccurence and malignant transformation.