ovarian cellular fibroma

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