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Case Reports in Medicine
Volume 2009 (2009), Article ID 802817, 4 pages
http://dx.doi.org/10.1155/2009/802817
Case Report

Ovarian Fibrosarcoma: Clinicopathologic Considerations about the Intraoperative and Post-Surgical Procedures

1Department of Pathology, University Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain
2Service of Gynecology, University Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain
3Service of Medical Oncology, University Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain

Received 7 October 2009; Accepted 15 December 2009

Academic Editor: Herman Yee

Copyright © 2009 Angel García Jiménez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Primary ovarian fibrosarcomas are very uncommon neoplasms. Since the diagnostic criteria were established in 1981, less than one hundred cases have been reported. This diagnosis can be difficult to establish and other similar appearing mesenchymal processes must be ruled out. In every case this diagnosis is under consideration. Multiple sections of the specimen and immunohistochemical stains will be necessary to support this diagnosis. The difficulty of recognition in frozen section in the majority of the situations implies that the diagnosis should be deferred to the definitive study of the permanent sections with immunohistochemical studies. There exists a histological resemblance between a primary ovarian fibrosarcoma and actively mitotic fibroma. In some cases, it can be impossible to separate exactly these two entities. We report a well-differentiated ovarian fibrosarcoma, with less than 1-2 mitosis HPF and low-grade cytological atypia, similar to active mitotic fibromas, developing liver metastasis one year later. Despite having distant metastasis, some cases with long survival rates have been reported in patients who received chemotherapy after surgery; so that the adjuvant chemotherapy should be considered, especially in young females.