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ovarian cellular fibroma

Tuesday 9 July 2013

Differential diagnosis

- diffuse adult granulosa cell tumor

  • Ovarian cellular fibromas are uncommon neoplasms, which may result in considerable diagnostic confusion with diffuse adult granulosa cell tumor.
  • This is an important distinction, as the former usually exhibits benign behavior, whereas the latter is a low-grade malignant neoplasm capable of recurrence and metastasis.
  • FOXL2 mutation (402C→G) has been demonstrated in >95% of ovarian adult granulosa cell tumors, only rarely in other ovarian sex cord-stromal neoplasms, and never in ovarian fibromas.
  • FOXL2 mutation analysis is a useful adjunct in distinguishing between diffuse adult granulosa cell tumor (mutation present) and cellular fibroma (mutation absent).
  • Mutation testing should be considered in problematic cases, as this will provide prognostic information for the patient.

References

- Ovarian Cellular Fibromas Lack FOXL2 Mutations: A Useful Diagnostic Adjunct in the Distinction From Diffuse Adult Granulosa Cell Tumor. McCluggage WG, Singh N, Kommoss S, Huntsman DG, Gilks CB. Am J Surg Pathol. 2013 Jun 14. PMID: #23774170#