Giant Mitotically Active Cellular Fibroma of the Ovary in an Adolescent

Mitotically active cellular fibroma (MACF) of the ovary is a rare stromal tumor, representing an intermediate entity between cellular fibromas and fibrosarcomas. While fibrosarcomas show aggressive clinical behavior with nuclear atypia and high mitotic counts, MACFs demonstrate increased mitotic activity without atypia. Pediatric cases are exceptionally uncommon.

A 15-year-old adolescent presented with an adnexal mass. Surgical excision revealed a large ovarian tumor, confirmed histopathologically as a mitotically active cellular fibroma. The tumor was the largest and heaviest MACF reported in a pediatric patient to date. The postoperative course was uneventful, and the patient remains under follow-up without recurrence.

Ovarian MACF is a rare diagnosis in children and adolescents. Its recognition is important, as it carries intermediate malignant potential and may mimic fibrosarcoma. Accurate histopathological evaluation is essential to guide management and prevent overtreatment, while ensuring appropriate follow-up for early detection of recurrence.