Atypical and borderline endometrioid adenofibromas of the ovary. A report of 27 cases

The significance of varying degrees of epithelial atypicality was investigated in 27 endometrioid adenofibromas and cystadenofibromas of the ovary. The tumors were classified as atypical or borderline on the basis of the degree of atypicality of the epithelial element. All tumors were confined to the ovary at the initial operation and most of them were treated by a hysterectomy and bilateral salpingo-oophorectomy. Seven tumors with mild to severe cytologic and architectural atypicality similar to that encountered in atypical endometrial hyperplasia were classified as atypical adenofibromas. No recurrences or deaths from tumor occurred in patients with this type of tumor during 1-18.5 years of follow-up. Twenty tumors that contained closely packed glands or epithelial islands with a cribriform pattern composed of cells with low-grade malignant nuclear characteristics embedded in an abundant fibromatous stroma without evidence of invasion were classified as borderline. Nineteen patients with tumors of this type had no evidence of disease 1-13 years after initial therapy. One of these tumors was discovered at autopsy. These data, although based on a relatively small series of cases, suggest that atypical endometrioid adenofibromas and those of borderline malignancy have an excellent prognosis.