Adenofibroma

Published on 06/06/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 22/04/2025

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Chapter 123 Adenofibroma

INTRODUCTION

Description: An adenofibroma is an epithelial tumor that consists of glandular elements and large amounts of stromal (fibrous) elements. Adenofibromas are most commonly found as ovarian masses. They may also occur in the cervix or uterine body. Adenofibromas are closely related to cystadenofibromas, which have cystic areas but still contain more than 25% fibrous connective tissue.
Prevalence: Uncommon.
Predominant Age: Perimenopausal and postmenopausal.
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Unknown.
Risk Factors: None known.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Asymptomatic (often an incidental finding after oophorectomy)
• Adnexal mass (adenofibromas are bilateral in 25% of cases)
• Fibrous cervical or endometrial polyp
• Acute abdominal pain if torsion occurs (rare)

DIAGNOSTIC APPROACH

Differential Diagnosis

• Thecoma (fibroma)
• Stromal and germ cell tumors
• Brenner tumor
• Endometrioma
• Benign cystic teratoma
• Serous or mucinous cystadenoma
• Metastatic tumors
• Pedunculated leiomyomata
• Endocervical polyp

Associated Conditions: None.

WORKUP AND EVALUATION

Laboratory: No specific evaluation indicated; evaluate as with other adnexal or cervical masses.
Imaging: Ultrasonography may suggest a solid tumor.
Special Tests: None indicated.
Diagnostic Procedures: Histopathology.

Pathologic Findings

Fibrous and epithelial elements make up this tumor. The epithelial components may be serous, mucinous, clear cell, or endometrioid. Epithelial or fibrous elements may predominate, changing the gross character of the tumor. Size is generally 1 to 15 cm in diameter.

MANAGEMENT AND THERAPY

Nonpharmacologic

General Measures: Evaluation and diagnosis.
Specific Measures: Simple surgical excision. Adenofibromas that are borderline or of low malignant potential do exist. These tumors must be treated on the basis of their size, location, and histologic evaluation, but they may require more extensive surgical therapy.
Diet: No specific dietary changes indicated.
Activity: No restriction.
Patient Education: Reassurance; American College of Obstetricians and Gynecologists Patient Education Pamphlet AP075 (Ovarian Cysts), AP096 (Cancer of the Ovary).

Drug(s) of Choice

None.

FOLLOW-UP

Patient Monitoring: Normal health maintenance.
Prevention/Avoidance: None.
Possible Complications: Torsion of solid ovarian tumors. Adenofibromas that are borderline or of low malignant potential may spread or recur.
Expected Outcome: Surgical excision is generally curative.

MISCELLANEOUS

Pregnancy Considerations: No effect on pregnancy.
ICD-9-CM Codes: Based on location and predominant cell type.

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REFERENCES

Level III

Fleischer AC. Transabdominal and transvaginal sonography of ovarian masses. Clin Obstet Gynecol. 1991;34:433.

Herman JR, Locher GW, Goldhirsch A. Sonographic patterns of ovarian tumors: prediction of malignancy. Obstet Gynecol. 1987;69:777.

Katz VL. Benign gynecologic lesions. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, editors. Comprehensive Gynecology. 5th ed. Philadelphia: Mosby/Elsevier; 2007:462.

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