Borderline Clear Cell Adenofibroma of Ovary -Report of a case-

초록

A pure clear cell adenofibromas of borderline malignancy constitute is extremely rare, comprising less than 1% of borderline tumors of the ovary. Microscopic architecture of this tumor is similar to that of the clear cell adenofibroma. However, the tumor has greater epithelial proliferation and significant cellular atypia than adenofibroma and lacks stromal invasion. We report a case of borderline clear cell adenofibroma of ovary. The patient was a 47 year-old woman who presented with 2-week history of lower abdominal pain and vaginal bleeding. She was menopausal 3 months. On abdominal ultrasonography, there was a 5-㎝, solid mass in her left pelvic cavity suggesting ovarian tumor. The endometrium was thickened up to 16㎜. Her pertinent laboratory workup showed mild anemia and normal CA 125 level. The patient underwent laparoscopy-assisted vaginal hysterectomy with left salpingo-oophorectomy. Gross pathologic examination revealed a left ovary replaced by a firm to rubbery tumor, measuring 5×4×3㎝. The tumor displayed a smooth lobulated external surface, and the cut surfaces had fine honeycomb appearance with minute cysts embedded in firm to rubbery stroma. Histologic sections showed widely and irregularly spaced or crowed glands, tubules and epithelial nests embedded in a dense fibrous stroma. However, there was no evidence of destructive stromal invasion or surface involvement. The glands and tubules were lined with one or occasionally more layers of hobnail or polygonal cells with clear to eosinophilic cytoplasm, moderate to severe nuclear atypia and prominent nucleoli. Some glands and tubules were filled with pale eosinophilic secretions. Psammomatous microcalcifications were occasional identified. Mitotic figures were inconspicuous. A focal area showing presumptive endometriosis was also present. The uterus was slightly enlarged with an intramural 3㎝-leiomyoma and adenomyosis.