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Ovarian Fibroma : Differential Diagnosis

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Differential Diagnosis: Conventional fibroma of the ovary should be distinguished from stromal hyperplasia, massive ovarian edema, and thecoma. Cellular fibroma and mitotically-active fibroma resemble fibrosarcoma, adult type granulosa cell tumor, and luteinized thecoma.

Stromal Hyperplasia: It is a diffuse, bilateral process that does not produce a single dominant mass lesion. There is a diffuse proliferation of ovarian stromal cells in the cortex and medulla of the ovary. It lacks the collagenous stroma and hyaline plaques seen with fibromas.

Massive Ovarian Edema: It is unilateral and closely resembles ovarian fibroma. However, there is no displacement or compression of normal ovarian structures such as follicles, corpora lutea, and corpora albicantia. (differential diagnosis continues in the next two images)

This image of an ovarian fibroma shows intersecting fascicles of bland, fibroblastic-type spindle cells in a collagenous stroma.

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