Myofibroblastoma of the ovary: report of a case

We report an unusual case of an ovarian tumor arising in a 22-year-old female that showed histologic, immunohistochemical, and ultrastructural features of myofibroblastic differentiation. The mass was found incidentally and upon excision was 9.0 cm in its greatest dimension and almost entirely replaced the left ovary. The patient is alive without evidence of disease 21 months after excision. Histologically, the tumor was encapsulated and composed of cytologically bland spindled cells arranged into a variety of patterns, similar to those found in both solitary fibrous tumor and hemangiopericytoma. Immunohistochemically, the cells stained strongly for smooth muscle actin and muscle-specific actin, with only focal and weak staining for CD34. Stains for S-100 protein, desmin, and AE1/AE3 were negative. Ultrastructurally, the neoplastic cells showed clear-cut evidence of myofibroblastic differentiation. The differential diagnostic considerations, including solitary fibrous tumor and hemangiopericytoma, are discussed.