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PubMed1998

Adenosarcoma of the uterine cervix presenting as a cervical polyp.

A case of adenosarcoma arising from the uterine cervix of a 55-year-old female who complained of vaginal discharge is reported. A polyp, 6 x 2 x 1.5 cm in size, identified in the cervical canal was clinically diagnosed as benign cervical polyp and resected. Histologically, the polyp was composed of benign epithelial components and sarcomatous stroma wherein periglandular hypercellularity and some mitoses including atypical ones were noted. Immunohistochemically, stromal cells were positive for muscle-type actins, desmin and estrogen receptor. Adenosarcoma is a rare, biphasic tumor of the uterus and usually presents as a polypoid mass in the endometrial cavity. When they arise from the cervix, adenosarcomas may be confused with benign cervical polyps clinically and pathologically. As the former often recurs, microscopic differentiation is crucial for further treatment.

Actins↗
PubMedDate not supplied

Müllerian adenosarcoma of the uterus: report of a case with imprint cytology.

BACKGROUND: Müllerian adenosarcoma is a rare morphologic variant of uterine sarcoma that, although well described histologically, is scarcely mentioned in the cytologic literature. CASE: A 75-year-old female was suspected of having atypical endometrial hyperplasia on an endometrial smear. However, subsequent imaging techniques revealed the presence of a bulky, polypoid mass filling the uterine cavity. On pathologic examination of the hysterectomy specimen, the polypoid tumor was diagnosed as mullerian adenosarcoma, homologous, with sarcomatous overgrowth, in which the sarcomatous component was compatible with high grade endometrial stromal sarcoma. Imprint smears of the tumor consisted of two morphologic patterns, sarcomatous and glandular. The sarcomatous tumor cells, with coarse chromatin and relatively scant cytoplasm, formed small aggregates or appeared alone. These cells were semiround or oval and had conspicuous nucleoli. In addition to these observations, small and large clusters of glandular cells with mild atypism were interspersed with the sarcomatous cells. CONCLUSION: Cytologic examination of müllerian adenosarcoma well reflects its pathologic features.

Adenosarcoma↗
PubMed2000

Uterine adenosarcoma with rhabdomyosarcomatous overgrowth. Brief communication.

A case of a rhabdomyosarcomatous uterine adenosarcoma with sarcomatous overgrowth is presented. The rhabdomyosarcoma component constituted about 90% of the tumor. The patient died 5 years and 5 months after the operation. Rhabdomyosarcomatous uterine adenosarcoma even with a sarcomatous overgrowth does not seem to be more malignant than other adenosarcomas.

Adenosarcoma↗
PubMed2001

Adenosarcoma of the uterine body in a 19-year-old woman--three year survival: case report.

BACKGROUND: Uterine adenosarcoma is a rarely by occurring tumor. It is composed of a benign adenoid structure and a sarcomatous stromal component. The average age of patients with a diagnosis of uterine adenosarcoma is about 70 years. CASE: We present a case of a 19-year-old woman with a rarely occurring uterine adenosarcoma manifesting itself by irregular bleeding and producing fragile polypous matter which was spreading into the vagina. The final diagnosis was made only by repeated biopsies. Abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy and revision of iliac lymph nodes were performed. Teleradiotherapy was applied from 4 fields in 25 fractions to a total exposure of 50 Gy. It was followed by six cycles of chemotherapy containing 50 mg/m2 doxorubicin and 5 g/m2 ifosfamid administered in 21-day dose intervals. CONCLUSION: This case should demonstrate the difficulty of making the right diagnosis. Since the end of therapy the patient has been regularly seen in our onco-gynecologic department. Now, 40 months after the end of chemotherapy and 46 months after making the diagnosis, there are no signs of relapse.

Adenosarcoma↗
PubMed2004

Adenosarcoma of the ovary. A case report.

Adenosarcoma of the ovary is a rare condition. We report a case of a 32-year-old patient that has been treated in our Department. The diagnosis of ovarian adenosarcoma was carried out after laparoscopy with removal of an ovarian endometriotic cyst. Laparoscopic homolateral ovariectomy was then performed and conservative treatment was decided on considering the young age, low stage and low grade of the disease. Second-look laparoscopy, clinical evaluation and ultrasound were performed for four years of follow-up. No recurrence has been detected. Conservative treatment should be proposed in fertile age with low-grade ovarian adenosarcoma, but a strict follow-up is always necessary.

Adenosarcoma↗
PubMed2005

Primary peritoneal adenosarcoma with stromal overgrowth and fetal type cartilage: a case report and literature review.

Primary peritoneal adenosarcoma with sarcomatous overgrowth and fetal-type cartilage presented in a 48-year-old female patient is described. The tumor seems likely to have derived from the pelvic peritoneum, wheareas the uterus, ovaries and tubes were uninvolved. It was composed of benign-appearing glands and a sarcomatous component showing cartilaginous differentiation. The extrauterine adenosarcomas were reported in other sites, e.g. cervix, ovary, fallopian tube, bladder, and peritoneum. This case was the ninth case of the primary peritoneal adenosarcoma in the English literature and the first report in Thailand.

Adenosarcoma↗
PubMed1990

Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature.

One hundred cases of mullerian adenosarcoma of the uterus were encountered in patients 14 to 89 years of age (median, 58 years), who usually had the symptom of abnormal vaginal bleeding. An enlarged uterus and tissue protruding from the external os were the most common findings on pelvic examination. Five patients presented on multiple occasions with "recurrent polyps" that were interpreted retrospectively as adenosarcomas. Primary treatment, known in 97 cases, included some form of hysterectomy in 93 of them, and conservative resection in four cases. Gross examination of the excised uteri disclosed polypoid masses, some of which had spongy cut surfaces, usually filling the endometrial cavity; less commonly, the tumors were confined to the endocervix or the myometrium or involved more than one site. Histologic examination revealed benign or atypical neoplastic glands within a sarcomatous stroma, which typically formed periglandular cuffs of increased cellularity, intraglandular polypoid projections, or both. The sarcomatous stroma was homologous in 78% of the cases and contained heterologous elements in the remainder. The stromal mitotic rate varied from 1 to 40 mitotic figures (MFs) (mean 9) per 10 high-power fields (HPFs). Extensive areas of stromal fibrosis that focally imparted a deceptively benign appearance to the tumor were common. Myometrial invasion was present in 15 cases, but was deep in only four. Recurrent tumor developed in 23 cases at postoperative intervals of 0.5 to 9.5 years (mean 3.4); in one third of such cases, the interval was 5 years or longer. Recurrent tumor was almost always confined to the vagina, pelvis, or abdomen; hematogenous spread occurred in only two cases. The only feature associated with an increased risk for recurrence was the presence of myometrial invasion. Criteria found useful in separating mullerian adenosarcomas from mullerian adenofibromas included, alone or in combination: two or more stromal MFs per 10 HPFs, marked stromal cellularity, and significant stromal cell atypia.

Adolescent↗
PubMed1989

Mullerian adenosarcoma of the cervix with heterologous elements: diagnostic and therapeutic approach.

Mullerian adenosarcoma of the cervix with heterologous elements is an extremely rare tumor first described by Roth and colleagues (L. M. Roth, G. L. Pride, and H. M. Sharma, Cancer 37, 1725-1736) in 1976. Since that time there have been only three subsequent reports of these cervical Mullerian adenosarcomas, which seem to occur most often in the postmenarchal age group. Due to the paucity of cases and the unknown biological potential of the tumor, therapy has ranged from simple excision to radical pelvic surgery and vaginectomy combined with both radiotherapy and chemotherapy. We report another case of Mullerian adenosarcoma of the cervix occurring in a teenage woman and make recommendations about diagnostic and therapeutic measures available to the physician.

Adolescent↗
PubMed1992

[Adenosarcoma of the uterus].

A case of a 67-year old woman with adenosarcoma of the uterus is reported. Adenosarcoma is a mixed mesodermal tumour with a low malignant potential. It is characterised by a benign glandular and a malignant stromal component. Adenosarcomas are usually treated by hysterectomy with bilateral salpingo-oophorectomy. Patients with myometrial invasion have an increased risk of recurrence. It may be appropriate, to consider adjuvant chemotherapy or radiation treatment for these patients.

Aged↗
PubMed1985

Rhabdomyosarcomatous uterine adenosarcoma.

A case of rhabdomyosarcomatous adenosarcoma of the uterine cervix is described and the literature reviewed. This variant of adenosarcoma does not appear to be more malignant than other adenosarcomas. It can and should be differentiated from embryonal rhabdomyosarcoma and malignant mixed müllerian tumor because of the different prognostic implications and therapeutic approaches.

Child↗
PubMed1992

Adenosarcoma of the uterus: a Gynecologic Oncology Group clinicopathologic study of 31 cases.

We report on the clinical and pathologic findings in 31 cases of adenosarcoma of the uterus subjected to hysterectomy and staging laparotomy. Nine of 30 patients (30%) have had recurrent tumor and six of 30 (20%) have already died of tumor in a relatively short follow-up period (mean, 38.3 months). Seventeen of 31 cases were diagnosed as adenosarcoma with sarcomatous overgrowth (SO). Ten of these 17 with SO contained focal or extensive rhabdomyosarcoma. In six cases, extrauterine spread was identified as follows (two patients had two sites each): vaginal involvement (two cases), pelvic lymph node metastases (two), positive peritoneal cytologic findings (two), parametrial invasion (one), and ovarian metastasis (one). Extrauterine spread (stage III) (p less than 0.001) and myometrial invasion (p = 0.04) were associated with higher rates of recurrence. The presence of lymphatic and/or vascular invasion, SO, and rhabdomyosarcomatous differentiation also indicated poor prognosis but did not attain statistical significance. Based on this experience, staging laparotomy including peritoneal cytology is suggested in cases of clinical stages I and II adenosarcoma. The differential diagnosis of these tumors is also discussed.

Adult↗
PubMed1990

[Mullerian adenosarcoma].

The Müllerian adenosarcoma is an extremely rare entity of tumours of the group of the Müllerian and mesodermal mixed tumours. This tumour seems to be a malignant transformation of the uterine papillary cystadenofibroma. The periglandular malignant transformation of the stromal component and the benign glandular structures are typical signs of the Müllerian adenosarcoma. In accordance with references the prognosis of the adenosarcoma is better than those of other Müllerian mixed tumours. The demonstrated cases warn against undervalue.

Aged↗
PubMed1982

Adenosarcoma of the ovary. A light- and electron-microscopic study with review of the literature.

This is a light- and electron-microscopic study of a large ovarian adenosarcoma in a 50-year-old woman as well as a review of the literature. The tumor showed a variety of müllerian type epithelia and a spectrum of stromal patterns including nonspecific fibroblastic, and endometrial type stroma. The latter ranged from normal-appearing to low-grade sarcoma. This study emphasizes the relationship of ovarian adenosarcoma to cystadenofibroma, on the one hand, and to malignant mixed müllerian (mesodermal) tumor, on the other. It appears that the mitotic count which is used as the primary means for the classification of smooth muscle and stromal tumors of the uterus, has less value in the assessment and prognostication of ovarian adenosarcomas.

Adenofibroma↗
PubMed1994

An unusual extrauterine variant of adenosarcoma with multiple recurrences over 16 years.

An unusual extrauterine (pelvic) variant of adenosarcoma is presented. A benign-appearing epithelium resembling fallopian tube epithelium is integrally mixed with malignant stroma that in all areas sampled is low-grade leiomyosarcoma. The tumor has behaved as a low-grade malignancy with four local recurrences over a 16-year period. Extrauterine adenosarcomas have rarely been reported in the literature; and one in which the stromal component is histologically all of smooth muscle differentiation is more unusual.

Adenosarcoma↗
PubMed1994

Extragenital adenosarcoma arising in the pouch of Douglas.

We describe a rare case of extrauterine adenosarcoma, the first arising in the Pouch of Douglas, in a 49-year-old premenopausal woman with an elevated CA 125. The tumor consisted of benign glandular and malignant stromal elements. There was no associated endometriosis. Previously reported cases of extragenital adenosarcomas are reviewed.

Adenosarcoma↗
PubMed1995

Primary extrauterine müllerian adenosarcoma of the peritoneum.

A case of an extrauterine Müllerian adenosarcoma of the pelvic peritoneum is described. The patient, a 16-year-old girl, presented with abdominal distension and pain. At laparotomy, a tumor was found originating from the left pelvic side wall. Light microscopic examination revealed a Müllerian adenosarcoma. Postoperatively she was treated with polychemotherapy. Seventy months after initial presentation she is still free of tumor.

Adenosarcoma↗
PubMed1995

Two unusual presentations of müllerian adenosarcoma: case reports, literature review, and treatment considerations.

Müllerian adenosarcomas of the uterus usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. Extraendometrial variants (originating in the ovary, adnexa, or myometrium) are much less common, and they tend to present at a more advanced stage due to their location. The sarcomatous portion of müllerian adenosarcoma can vary from low grade to very high grade and the clinical behavior of the tumors can be indolent or aggressive. We present two cases, one of which originated in the adnexa and the other in an apparent focus of uterine adenomyosis. These cases illustrate the difficulty of correct diagnosis and treatment.

Adenosarcoma↗
PubMed2000

Vaginal adenosarcoma arising from endometriosis.

OBJECTIVE: Malignant transformation of endometriosis has been well documented. Endometrioid adenocarcinoma is the most common malignancy to occur in this setting, although other carcinomas and rarely stromal tumors can be seen. We present the first case in the literature of adenosarcoma, a rare mixed mullerian or mesodermal tumor, arising in extrauterine vaginal endometriosis. CASE: A 42-year-old woman underwent multiple medical therapies and surgeries for aggressive endometriosis. A pelvic exenteration was abandoned secondary to severe fibrosis, and low-dose radiotherapy was used to control bleeding from vaginal endometriosis. The pathologic diagnosis of recurrent endometriosis was confirmed multiple times over her 4-year course. Excision of a recurrent vaginal mass revealed adenosarcoma with heterologous elements. CONCLUSION: It is important to biopsy or excise recurrent endometriosis, as malignant transformation can occur, giving rise to epithelial, stromal, or mixed epithelial-mesenchymal tumors.

Adenosarcoma↗