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Review
. 2025 Jan-Mar;66(1):39-49.
doi: 10.47162/RJME.66.1.03.

Endometrioid adenofibroma of ovary - a literature review

Laurenţiu Augustus Barbu  1 , Liviu Vasile, Tiberiu Ştefăniţă Ţenea-Cojan, Gabriel Florin Răzvan Mogoş, Valeriu Şurlin, Ionică Daniel Vîlcea, Liliana Cercelaru, Stelian Ştefăniţă Mogoantă, Nicolae Dragoş Mărgăritescu
Affiliations
Review

Endometrioid adenofibroma of ovary - a literature review

Laurenţiu Augustus Barbu et al. Rom J Morphol Embryol. 2025 Jan-Mar.

Abstract

Background/objectives: Ovarian neoplasms are the third most common gynecological cancer and carry a poorer prognosis than breast cancer. Endometrioid borderline ovarian tumors (EBOTs) are intermediate epithelial lesions, histologically showing glandular patterns with mild to moderate atypia and no stromal invasion. Study selection for review: A comprehensive electronic search was conducted on PubMed to identify risk factors and etiological determinants associated with ovarian endometrioid adenofibroma (EA).

Case presentation: A 27-year-old woman with a left ovarian cyst underwent a laparoscopic procedure to remove the adnexa after imaging showed a 6 cm mass. Surgery was successful, and she was discharged without complications.

Conclusions: This study highlights the diagnostic challenges of EBOTs, the essential role of immunohistochemistry, and the need for careful surgical and fertility-preserving strategies. It also draws attention to possible risks linked to fertility treatments. Fertility preservation is crucial in young patients, favoring uterine and ovarian conservation. In early-stage, small, non-invasive tumors, laparoscopy is the preferred approach. EAs are uncommon benign ovarian tumors, accounting for approximately 1% of epithelial neoplasms, and are predominantly unilateral.

Keywords: borderline ovarian tumors; conservative surgery; endometrioid adenofibroma of ovary; laparoscopic ovarian resection.

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Conflict of interest statement

The authors declare that there is no conflict of interests.

Figures

Figure 1
Figure 1
(A and B) Ovarian cyst confined within pelvic adhesions, resulting in the cyst being adhered to surrounding structures, making its removal more complex
Figure 2
Figure 2
(A and B) Intraoperative visualization of an endometrioid adenofibroma cyst, characterized by its cystic structure and dense fibrous component, consistent with its typical histological presentation
Figure 3
Figure 3
Ovarian parenchyma. Epithelial tumor proliferation with irregular glandular structures (black arrow) and squamous morules (black asterisk). Hematoxylin–Eosin (HE) staining, ×100
Figure 4
Figure 4
Ovarian parenchyma. Epithelial tumor proliferation glandular structures lined by endometrioid-like epithelium with stratification and low-grade atypia (black arrow) and squamous morules (black asterisk). HE staining, ×200
Figure 5
Figure 5
Ovarian parenchyma. Fibrous stroma (black circle) of the epithelial tumor proliferation. HE staining, ×400
Figure 6
Figure 6
The tumor cells tested positive for estrogen receptors (ERs). Anti-ER antibody immunomarking, ×400
Figure 7
Figure 7
Ki67 showed focal positivity in up to 30% of the tumor cells. Anti-Ki67 antibody immunomarking, ×400
Figure 8
Figure 8
The tumor cells were positive for cytokeratin 7 (CK7). Anti-CK7 antibody immunomarking, ×400
See this image and copyright information in PMC

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