Benign and borderline clear cell adenofibromas of the ovary

The criteria for the diagnosis of benign and borderline clear cell adenofibromas and their biologic behavior were investigated by examination of the clinical and pathologic features of 18 tumors in these categories. Three tumors that showed no significant epithelial atypicality were classified as benign. Twelve tumors that contained glands or small solid nests composed of epithelial cells with nuclear characteristics of low-grade malignancy without invasion of the stromal component of the tumor were designated as borderline. Three predominantly borderline tumors with focal microinvasion of the stromal component were also studied. The 17 patients had nonspecific complaints. Sixteen of the tumors were unilateral without surface involvement; one patient had bilateral borderline tumors. Most of the women were treated by hysterectomy and bilateral salpingo-oophorectomy. Follow-up information was available for 16 of the 17 patients. No recurrences or deaths from tumor occurred in 14 patients (2 benign, 10 borderline, 2 microinvasive). One patient with a borderline adenofibroma had questionable lung metastasis 4 years after presentation, and another patient who had a microinvasive tumor had a pelvic recurrence 3.3 years postoperatively.