Mitotik aktif sellüler fibrom

Ovaryal sellüler fibromlar ve fibrosarkomlar oldukça nadir görülmektedir. Sellüler fibrom ile fibrosarkomun ayırıcı tanısında yakın zamana kadar mitoz sayısının en önemli kriter olduğu rapor edilmekte idi. Ancak son zamanlarda yüksek mitotik figür içerdiği halde iyi prognoz sergileyen olgular sunulmuştur. Burada sıra dışı bir fibröz tümör sunulmuştur. 18 yaşındaki hastaya ovaryal tümör tanısı ile salpingo-ooforektomi uygulandı. Makroskopik olarak kesi yüzünde sarımtırak multilobüler alanlar izlendi. Tümörde nekroz veya hemorajiye ait bir bulgu yoktu. Mikroskopide tümör iki komponentten oluşmaktaydı. Birisi sarımtırak alanlara uyan 10 büyük büyütme alanında 10'dan fazla sayıda mitoz içeren ama nükleer atipisi şiddetli olmayan sellüler alanlar, diğeri ancak bir kaç adet mitoz içeren nükleer atipisi ve şiddetli sellülaritesi olmayan alanlardı. Patolojik olarak tümör mitotik aktif sellüler fibromu düşündürmekteydi. Biz burada çok sayıda mitotik figür içeren ancak şiddetli nükleer atipi bulundurmayan oldukça nadir bir ovarian fibröz tümörü sunduk. İki senelik izlemde hastada nüks saptanmadı.

Mitotically active cellular fibroma

Ovarian fibrosarcomas and cellular fibromas are very rare tumors. Mitotic activity is reported to be the most important factor in differantial diagnosing fibrosarcoma and cellular fibroma. However, recent case reports have suggested that such tumors with a high number of mitotic figures often have favorable outcomes. An 18-year-old woman was diagnosed with ovarian tumor and underwent salpingo-oopheroctomy. Macroscopically the cut surface of the tumor showed yellowish multilobular areas. There was no sign of necrosis or hemorrhage within the tumor. Microscopically the tumor consisted of two components. One corresponded to the yellowish areas; there were more than 10 mitotic figure per 10 high-power fields but nuclear atypia was not severe in the cellular area. In the other component, there were few if any mitotic figures, there was no nuclear atypia and marked cellularity. Pathologically, the tumor was considered a mitotically active cellular fibroma. Herein, we report on a patient with a rare ovarian fibrous tumor with a large number of mitotic figures but without severe nuclear atypia. There was no recurrence after a 2-year follow-up.

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