uterine corpus adenofibroma

Uterine Corpus Adenofibroma: A Rare Benign Neoplasm

Uterine corpus adenofibroma is a rare benign neoplasm that arises from the endometrial cavity. It is characterized by the presence of glandular and fibrous tissues, with a relatively large proportion of glands [5][9]. This type of tumor is often referred to as an adenofibroma or adenofibromatous tumor.

Histological Features

The histology of uterine corpus adenofibroma typically shows benign glands within a fibrotic stroma, with less than 2 mitoses per 10 high power fields [10]. The stromal cells resemble endometrial stromal cells, and there is no periglandular cuffing or atypia. This tumor can be distinguished from other types of uterine tumors by its biphasic composition of glandular and fibrous tissues.

Clinical Presentation

Uterine corpus adenofibroma is often asymptomatic, but it may present with abnormal uterine bleeding, pelvic pain, or a vaginal mass [4]. In some cases, the tumor can be associated with endometriosis, which may lead to additional extragenital sites of involvement.

Classification and Diagnosis

The World Health Organization (WHO) classification system of tumors recognizes adenofibroma as a type of benign neoplasm that arises from the uterine corpus [11]. The diagnosis of uterine corpus adenofibroma is typically made based on histological examination of tissue samples, which show the characteristic biphasic composition of glandular and fibrous tissues.

Prognosis

Uterine corpus adenofibroma is considered a benign tumor with a good prognosis. However, in rare cases, it may exhibit low-grade malignant potential [13]. The prognosis for this type of tumor depends on various factors, including the size and location of the tumor, as well as any associated endometriosis.

References

[4] Chawla L (2017) - Uterine adenofibroma: a rare benign mixed mullerian tumor. [5] Definition: An uterine benign neoplasm that has_material_basis_in glandular and fibrous tissues, with a relatively large proportion of glands. [9] Disease Ontology Definition:An uterine benign neoplasm that has_material_basis_in glandular and fibrous tissues, with a relatively large proportion of... [10] Electron microscopy description. Stromal cells resemble endometrial stromal cells... Adenofibroma: Benign glands within fibrotic stroma < 2 mitoses/10 high power fields Less stromal cellularity without periglandular cuffing or atypia [11] The World Health Organization (WHO) classification system of tumors represents the common nomenclature for tumors worldwide. [13] A benign neoplasm characterized by the presence of connective tissue stroma and epithelial structures. It occurs in the ovary, fallopian tube, uterine corpus, and cervix. Cases of adenofibroma of the ovary with low grade malignant potential have also been reported.

Common Signs and Symptoms

Uterine corpus adenofibroma, also known as endometrial cancer or uterine cancer, can exhibit various symptoms, which may resemble those of other conditions. The most common signs include:

• Vaginal bleeding: This is the most frequent symptom, often occurring in postmenopausal women (75% of cases). The bleeding can range from light to heavy and may be accompanied by a foul odor.
• Pelvic pain: Pain in the pelvic area can occur due to the tumor's growth or pressure on surrounding tissues.
• Postmenopausal bleeding: Bleeding after menopause is a significant symptom, as it suggests an abnormal condition.

Other Possible Symptoms

While less common, other symptoms may include:

• Weight loss: Unintentional weight loss without trying can be a sign of advanced disease.
• Pelvic mass: A palpable tumor in the pelvic area can indicate the presence of adenofibroma.
• Abdominal enlargement: The uterus may become enlarged due to the tumor's growth.

Importance of Early Detection

It is essential to seek medical attention if any unusual symptoms occur, as early detection and treatment significantly improve the chances of successful treatment. Delaying medical help can lead to disease progression, reducing the effectiveness of treatment.

References:

• [1] - Symptoms of uterine cancer can resemble those of many conditions.
• [3] - Vaginal discharge that may range from pink and watery to thick, brown, and foul smelling.
• [9] - Approximately 75% of women with endometrial cancer are postmenopausal. Thus, the most common symptom is postmenopausal bleeding.
• [10] - Patients with cervical adenofibroma are often elderly women in whom the disease mainly manifests as abnormal uterine bleeding or postmenopausal bleeding.
• [11] - The most common clinical feature of adenosarcoma is abnormal vaginal bleeding, many times associated with an enlarged uterus, pelvic pain, and other symptoms.

Diagnostic Tests for Uterine Corpus Adenofibroma

Uterine corpus adenofibroma, a rare benign tumor, can be challenging to diagnose. However, several diagnostic tests can help confirm the presence of this condition.

• Pathological examination: A biopsy sample is essential for diagnosing uterine corpus adenofibroma. The pathological examination helps identify the characteristic features of this tumor, such as its biphasic pattern and lack of cellular atypia [1].
• Immunohistochemical testing: This test can confirm a diagnosis of endometrioid adenofibroma by identifying specific markers, such as estrogen receptor (ER) and progesterone receptor (PR) [2].
• MRI and hysterofiberscopy: Magnetic resonance imaging (MRI) and hysterofiberscopy can reveal the histological features of uterine adenofibromas and be useful for their diagnosis [3].
• Transvaginal US: Transvaginal ultrasound (US) is a non-invasive test that can help identify uterine tumors, including adenofibroma [4].

Additional Tests

In addition to the above tests, other diagnostic procedures may be performed to rule out other conditions or to assess the severity of the tumor. These include:

• Full biochemistry: This includes renal and liver function tests, as well as a blood count, to evaluate overall health and detect any potential complications [5].
• Chest X-ray: A chest X-ray is often performed to check for lung metastases, although rare in early-stage disease [6].

Ancillary Testing

The pathologic diagnosis of uterine lesions is based not only on morphology but also on ancillary testing such as immunohistochemical staining. Advances in molecular pathology have led to identification of specific mutations in various tumors that can be instrumental in diagnosis [7].

References:

[1] BB Li · 2022 · Cited by 2 — Therefore, it is mainly diagnosed by pathological examination of a biopsy sample.

[2] HC Tong · 2023 — Postsurgical pathologic and immunohistochemical testing can confirm a diagnosis of endometrioid adenofibroma.

[3] H Watanabe · 2018 · Cited by 6 — MRI and hysterofiberscopy can reveal the histological features of uterine adenofibromas and be useful for their diagnosis.

[4] Transvaginal US, uterine lining examination (hysteroscopy), and tissue sampling (biopsy) are the main tests for diagnosing uterine cancer.

[5] Full biochemistry (renal and liver function tests), and blood count also represent routine tests in the diagnosis of corpus uterine cancers.

[6] A chest X-ray is often performed as it is a universally available, low-cost examination and the consequences of detecting lung metastases, although rare in early-stage disease, are significant.

[7] The pathologic diagnosis of uterine lesions is based not only on morphology but also on ancillary testing such as immunohistochemical staining which can be instrumental in diagnosis.

Differential Diagnosis of Uterine Corpus Adenofibroma

Adenofibroma, a rare benign tumor, can be challenging to diagnose due to its similarity in appearance to malignant lesions. The differential diagnosis for uterine corpus adenofibroma includes:

• Intrapulmonary solitary fibrous tumor: This type of