Ovarian benign clear cell adenofibroma in a patient with premature ovarian failure after 8-year hormone replacement therapy

Ovary benign clear cell adenofibroma (CCAF) is extremely rare. Here, we reported a 38-year-old woman with CCAF who was given sequential cyclic hormone replacement therapy for eight years due to premature ovarian failure (POF). At operation, we found adenofibromas in both ovaries and well encapsulated. The cut surface was cystic and solid in appearance, and multilocular cysts embedded in hard stroma. Determination of sex hormone levels in the fluid of cysts of the ovary showed normal level. Clear cell cystadenofibroma proliferation was found in ovarian stroma while atrophy in ovarian cortex. Histological examination revealed that the glands were lined by 1 or 2 layers of hobnail cells with scant to moderate pale or clear cytoplasm. The nuclei were small uniform, and flat to round. Neither primary follicles nor secondary follicles were observed in ovary cortex. Immunohistochemical results showed that EMA and p53 were positive while Calretinin was negative. In this article, we reviewed literatures and analyzed both clinical and pathological features of ovary benign clear cell adenofibromas.