Hindawi Publishing Corporation
Case Reports in Obstetrics and Gynecology
Volume 2013, Article ID 308464, 3 pages
http://dx.doi.org/10.1155/2013/308464
Case Report
Adenofibroma in a Young Patient: A Rare Entity in
an Uncommon Age
R. Maciel, S. Carvalho, M. Teixeira, and M. J. Areias
Department of Obstetrics and Gynecology, Centro Hospitalar do Porto, Portugal
Correspondence should be addressed to R. Maciel; raquelmaciel@gmail.com
Received 29 October 2013; Accepted 16 December 2013
Academic Editors: E. Cosmi and P. McGovern
Copyright © 2013 R. Maciel et al. Tis is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Adenofbroma is an extremely uncommon benign tumor composed of glandular and fbrous tissues. It occurs more ofen in the
endometrium but it can also occur in the cervix and extrauterine sites. We report a case of a 32-year-old asymptomatic woman with
cervical adenofbroma, frst detected in a routine endovaginal ultrasound, as a cervical mass containing multiple cystic components.
Histopathologic fndings diagnosed its nature. As adenofbromas are very rare, we present this case with a brief review of the
literature.
1. Introduction
Endometrial adenofbroma is a rare benign mullerian mixed
tumor composed of benign epithelial and mesenchymal
components. Te major proportion of adenofbromas arise
from the endometrium (90%); less ofen occur in the cervix
[1] and in other anatomical locations. When this tumor arises
in the cervix, women can present with abnormal vaginal
bleeding, as a frst sign. It can occur in any age but is
most commonly seen in peri- or postmenopausal women
[2]. Tere are no typical preoperative patterns (clinical or
sonographic) that strongly suggest this diagnosis. Te major
concern before this benign mixed mesodermal tumor must
be its diferential diagnosis with other malignant lesions
of the uterus, particularly adenosarcoma. Other diferential
diagnoses are adenomyoma and carcinosarcoma [3, 4].
We report a case of an adenofbroma of the uterine cervix
in a young patient.
2. Case Report
A 32-year-old, nulliparous, woman went to her gynaecologist
for routine procedures. She had no complaints and referred
regular menstrual cycles, with oral combined contraception.
Pelvic examination was normal. Endovaginal ultrasound
revealed an intracervical multicystic mass, with 45 mm in its
maximum diameter (Figure 1). Diagnostic hysteroscopy was
performed and a frm and palid polypoid mass containing
multiple cystic spaces and some foci of hemorrhage was
detected (Figure 2). Te histopathological examination of the
biopsy specimen disclosed an adenofbroma of the uterine
cervix: endometrial glands without architectural complexity
or cytologic atypia, surrounded by stroma of smooth muscle.
An operative hysteroscopy (resectoscopy) with total resection
of the tumor was performed. Te histological examination
confrmed its benign origin. Te follow-up ultrasound, three
months later, was normal, with a linear endocervical epithe-
lium (Figure 3) and the patient was asymptomatic.
3. Discussion
It was in 1971, by Abell, that adenofbroma of the uter-
ine cervix was frst described [5]. Tere have been few
reports since then. A literature review carried out using the
Pubmed search, with the words “cervical adenofbroma”—
and subsequent flters, demonstrated less than 10 manuscripts
published.
In fact, as a result of its low incidence, the origin of
this tumor is still a source of debate; some authors believe
it represents a form of endometriosis with extreme smooth
muscle metaplasia—endomyometriosis [6]. More recently,
Chu et al. (2012) reported a case of an adenofbroma of the
uterine cervix coexistent with endometriosis [3].