OC04.03: Ultrasound and histopathologic correlation of ovarian cystadenofibromas: the pathognomonic “shadow sign”

To delineate the histopathologic basis of the typical sonographic features of cystadenofibromas with their pathognomonic “shadow sign”. A description of this benign entity will allow clinical providers to defer surgical removal in appropriate cases and even question routine sonographic follow-up (Goldstein et al). Our ultrasound database was searched for diagnoses of “cystadenofibroma” and “cystadenoma” between 2010 and 2017, The database of Surgical Pathology was used to match the US database cases, had their ovary surgically removed and diagnosed by histopathology as cystadenofibroma. These cases were the subject of this study. The US database yielded 821 cases diagnosed as CAF and CAD. Of these 155 were surgically removed and histopathologically examined. 20 had matching US and histopathologic evaluation of cystadenofibroma. Aiming for slides where the microscopic specimen was able to slice across and represented the sonographically identified nodule, we identified 20 such pairs. All histopathologic descriptions of the hyperechoic, avascular, shadowing nodules seen on sonograms were: stroma containing uni or multilocular cyst lined with columnar or cuboidal cells resembling tubal epithelium with a fibrous nodule where the solid stroma contained spindle fibroplasts. These are typical for the diagnosis. One representative image pair is included here (figure 1). All pairs will be presented at the lecture or poster. The pathognomonic sonographic markers of benign, ovarian cystadenofibromas are inner wall nodules with, their acoustic shadowing cast by solid, histologically proven fibrous tissue. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.