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The clinicopathologic features of 34 cystadenofibromas were analyzed and compared to those of 39 serous cystadenomas. The clinical features of the patients with cystadenofibromas were similar to those of the patients with cystadenoma. Pathologic features showed the following differences: Papillary projections of cystadenofibromas consisted of short, broad, firm structures which were frequently hyalinized. Those of cystadenomas were slender, delicate and friable showing less frequent hyalinization. Epithelial elements in both tumors were similar to those seen in a variety of neoplasms of müllerian derivation. However, while all the cystadenofibromas were histologically unequivocally benign, 6 cystadenomas showed epithelial tufting, 5 mitoses and atypia each, and 3 of these were diagnosed as borderline malignant. Characteristic histologic findings in the cystadenofibromas established beyond doubt their origin from germinal epithelium and underlying stroma, whereas in some of the other ovarian tumors of müllerian derivation, the cellular origin often remains conjectural at best. We concluded that ovarian cystadenofibroma is more common than generally believed and that is of an entirely benign nature, necessitating only conservative surgical therapy. The characteristic pathologic features of this neoplasm justify its separate listing in the group of müllerian ovarian tumors of surface epithelial and ovarian stromal origin.

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