title: Ovarian fibroma/fibrothecoma: retrospective cohort study shows limited value of risk of malignancy index score.
abstract: BACKGROUND
  Ovarian fibromas/fibrothecomas are uncommon benign tumours of ovary. Due to their solid structure, these benign tumours are sometimes confused with malignant tumours during clinical evaluation.
  
  
  OBJECTIVE
  To determine the clinico-pathological characteristics of ovarian fibroma/fibrothecoma and analyse the efficiency of risk of malignancy index (RMI) scoring system to distinguish malignancy among these tumours.
  
  
  METHODS
  Between November 2001 and February 2012, women with a pathological diagnosis of ovarian fibroma/fibrothecoma were identified. Depending on the menopausal status, serum CA-125 level and ultrasonographic findings, RMI scores were calculated for each of the patients.
  
  
  RESULTS
  During the study period, 43 ovarian fibroma/fibrothecoma (4.7%) were detected among 912 adnexal masses operated. The mean age of the women was 52.2 (range, 21-80 years). Upon calculating RMI scores, 33 women (76.7%) were classified as low risk and 10 women (23.3%) as high risk for malignancy. Sensitivity, specificity, positive predictive value and negative predictive value of the RMI scoring for identification of malignant lesions preoperatively were found as 0%, 76%, 0% and 97%, respectively. Final pathological diagnosis was ovarian fibroma in 13 (30%) women, fibrothecoma in 29 (67%) and fibrosarcoma in one woman (2%).
  
  
  CONCLUSIONS
  There are no specific markers for accurate preoperative diagnosis of ovarian fibroma/fibrothecoma. Moreover, according to our results, RMI scoring system does not aid clinicians in this issue either, with a high false-positive rate and very low sensitivity. Further studies with higher number of cases are needed to state clearly the role of RMI scores in preoperative discrimination of malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Numanoglu
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Kuru
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sakinci
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akbayır
authors.forename: Volkan
authors.initials: V
authors.lastname: Ulker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D017698:Postmenopause; D011237:Predictive Value of Tests; D017697:Premenopause; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013798:Thecoma / Q000175:diagnosis* / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen