Cervical Adenofibroma: A Rare Cause for Postmenopausal Bleeding

Adenofibroma of the cervix is an extremely rare benign Mullerian mixed tumor, which contains both benign epithelial and mesenchymal tissue. The WHO 2020 classification of the female genital tract does not even include adenofibroma as a separate entity. A postmenopausal lady in her mid-50s presented with bleeding per vagina. On examination, there were multiple cervical polyps. Histopathology of cervical polyps suggested adenofibroma of the cervix due to the absence of mitotic figures and cellular atypia. Sometimes even well-differentiated adenosarcomas can be misdiagnosed as adenofibroma. Immunohistochemistry markers help in differentiating adenosarcoma from adenofibroma. There are no typical clinical or imaging characteristics that strongly suggest the diagnosis. Although adenofibroma is a benign tumor; still it has been found to invade the myometrium and pelvic veins, relapse, and metastasize. It is crucial to perform a detailed histopathological examination of all the cervical tumors not only to exclude malignant lesions but also to exclude adenofibroma regardless of clinical symptoms.