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PubMed1987

Infected müllerian adenosarcoma of the endometrium.

A 52-year-old postmenopausal woman presented with signs and symptoms of acute pelvic inflammatory disease. On vaginal speculum examination, an infected polypoid tumor protruding from a dilated cervical canal was disclosed. While the patient was under extensive antibiotic treatment, uterine curettage was performed. This was followed a few days later by a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination demonstrated the tumor to be Müllerian adenosarcoma of the uterine endometrium. The patient had postoperative vaginal vault irradiation, and more than 1 year later she is alive with no evidence of recurrent disease. Diagnosis and management of uterine Müllerian adenosarcoma is discussed.

Acute Disease↗
PubMed1992

Mullerian adenosarcoma of the uterus with sarcomatous overgrowth.

A case of mullerian adenosarcoma of the uterus with sarcomatous overgrowth is described. The patient was also found to have bilateral polycystic ovaries. This 25 year-old white female presented with irregular vaginal bleeding and was diagnosed as having mullerian adenosarcoma with sarcomatous overgrowth by dilatation, curettage, and biopsy. Total abdominal hysterectomy, bilateral salpingo-oophorectomy with lymph node sampling were performed.

Adult↗
PubMed1993

Dedifferentiated extrauterine adenosarcoma responsive to chemotherapy.

Extrauterine adenosarcoma, a low-grade mixed mesodermal tumor, is an uncommon neoplasm. Little information is available regarding the efficacy of treatment of tumors not amenable to surgical resection. Our patient's pelvic adenosarcoma progressed despite multiple attempts at surgical excision over an 8-year period. Hormonal therapy with medroxyprogesterone acetate and tamoxifen did not alter the frequency of recurrence. However, aggressive cisplatin-ifosfamide-based combination chemotherapy produced a dramatic response in the metastatic tumor in the liver. Cisplatinum, doxorubicin, and ifosfamide may thus be active against this tumor. Regional arterial infusion, when feasible, may enhance response.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1981

[Heterologous Müllerian adenosarcoma of the uterus--a rare tumor. Light- and electron-microscopic findings, biological behavior (author's transl)].

A case of heterologous Müllerian adenosarcoma of the uterus is presented with emphasis on morphologic differentiation, clinical course, prognosis, and treatment. This tumor was described first by Clement and Scully in 1974. Since that time 36 cases have been reported in the literature. The neoplasm consists of benign epithelial and malignant mesenchymal elements. The latter are composed of tissue with homologous and heterologous differentiation. Our microscopic and ultrastructural studies suggested that the heterologous elements were rhabdomyoblasts with a variable degree of differentiation. According to the literature the prognosis of Müllerian adenosarcoma is better than that of malignant mixed Müllerian tumor. The location of the tumor - whether intrauterine or extrauterine - seems to be more important as regards prognosis than the differentiation of the sarcomatous elements. The clinical course in our patients was not different from those described in the literature. Surgical removal of the tumor remains the treatment of choice. Some authors report a better survival rate when surgical treatment is followed by radiotherapy. Chemotherapy may be useful in cases of local or distant metastasis, and in cases of incomplete excision of the tumor mass.

Cell Differentiation↗
PubMed1991

Müllerian adenosarcoma of the uterus with pure angiosarcoma: case report.

We report a case of müllerian adenosarcoma of the uterus with benign endometrioid epithelial component and histologically pure angiosarcoma. This seemingly unique sarcomatous ingredient, among uterine and extrauterine adenosarcomas reported in the English literature, is considered to be a homologous component of the tumor. The patient, a 71-year-old woman with a several-month history of intermittent vaginal bleeding, was found at abdominal hysterectomy to have a large polypoid intrauterine tumor with superficial extension into the myometrium. The patient was treated with 6,000 rad of adjuvant radiation but died a few months after of what clinically appeared to be massive abdominal bleeding. The literature regarding uterine tumors classified as angiosarcoma or malignant hemangioendothelioma is briefly reviewed.

Aged↗
PubMed1992

Uterine mullerian adenosarcoma following adenomyoma in a woman on tamoxifen therapy.

The clinical and pathologic findings in a 53-year-old woman who developed a uterine adenosarcoma following an adenomyoma are described. During the interval between the diagnosis of adenomyoma and the subsequent diagnosis of adenosarcoma, the patient developed breast carcinoma and received adjuvant chemotherapy that included tamoxifen. The possible stimulatory effects of this drug upon the patient's pre-existing adenomyoma are discussed in view of reports of tamoxifen-associated endometrial carcinoma and uterine sarcomas developing in the setting of estrogen excess.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

CT of mullerian adenosarcoma arising in endometriosis.

Mullerian adenosarcoma is a rare tumor that usually arises in the uterus. Occasional cases arising in endometrial implants have been reported. We report the computed tomography (CT) findings of histologically proven mullerian adenosarcoma arising in perirectal endometriosis in a 46-year-old woman.

Adenocarcinoma↗
PubMed1988

Mullerian adenosarcoma of the uterine cervix.

The management of cervical adenosarcoma in a 14-year-old girl is described. The tumor had an exceptionally violent biological nature and did not respond to a variety of customary and unorthodox therapeutic measures. These included conventional intravenous chemotherapy, radiation therapy, surgery, intraarterial chemotherapy, colostomy, and peritoneovenous shunt for untreatable ascites. The patient died within 16 months of diagnosis. This is the fifth case of cervical adenosarcoma in the English literature. This tumor usually has a better prognosis and none of the previous four cases succumbed to the disease. The unusual virulence of the present case is discussed and the literature reviewed.

Adolescent↗
PubMed1995

[Müllerian adenosarcoma of the uterus. A case report].

A case of Müllerian adenosarcoma of the uterus is described. The patient, an 81-year old female, was treated in hospital for vaginal bleeding in 1993. She was diagnosed as having a tumour of the uterus. The patient underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy. We found a polypoid intrauterine tumour which had led to a swelling of the cavum and cervical canal. Histologically a Müllerian adenosarcoma was diagnosed. The tumour consisted of a benign glandular component and an mesenchymal component in the form of a low differentiated pleomorphic rhabdomyosarcoma.

Aged↗
PubMed1979

Müllerian adenosarcoma of the uterus. Clinicopathologic report of five cases.

The clinicopathologic features of five cases of müllerian adenosarcoma of the uterus are presented and are compared with those of previously reported cases. Four tumors were localized in the endometrium; in one case, a cervical or endometrial origin was not clear. The ages of the patients ranged from 53 to 79 years. Two died without clinical evidence of recurrence 19 and 18 years after hysterectomy. One was alive and well 10 years postoperatively and one was lost to follow-up 6 months after therapy. In one case, a first abdominal recurrence was resected 5 years and 9 months after hysterectomy; the patient died of a second abdominal recurrence 18 months later. The tumors were bulky polypoid masses producing metrorrhagia. Histologically, a sarcomatous component was intimately associated with benign epithelium of various müllerian types. The neoplasm was typically organized in papillary fronds and periglandular sarcomatous cuffs. Cystic glands were also a constant feature. Mitoses were generally fewer than 10 per 10 high-power fields, except in one case where they were 44 in a more malignant-appearing area. Adenosarcoma must be differentiated from other müllerian tumors, mainly carcinosarcoma whose prognosis is much less favorable.

Aged↗
PubMed1979

Müllerian adenosarcoma of the uterine body: a report of nine cases.

Nine cases of Mullerian adenosarcoma of the uterine body, first defined in 1974 by Clement & Scully, are described. The tumour usually occurs in elderly women and appears macroscopically as a polypoid mass filling the uterine cavity. Histologically these neoplasms are characterized by having a benign epithelial component set in a sarcomatous stroma. The epithelial element consists of tubular glands, cystically dilated glands and a surface epithelium. The glandular and surface epithelium usually resembles that of proliferative endometrium but may be of mucinous type and can undergo squamous metaplasia. Occasional mitotic figures, multilayering and intraluminal tufting are seen in the actively growing but benign glands which are considered to be an integral component of the tumour. The sarcomatous stroma contains spindle cells, round cells and, less frequently, multinucleated giant cells and rhabdomyoblasts. The Mullerian adenosarcoma represents a relatively benign variant of the mixed mesenchymal sarcoma of the uterus and is probably more common than is generally realized. Myometrial invasion is rarely deep and the majority of patients with this neoplasm survive. Vaginal recurrence occurs only in a minority of patients and distant metastasis is exceptional.

Aged↗
PubMedDate not supplied

[High-grade sarcoma with areas of mullerian adenosarcoma of the uterus].

This paper describes a case of mullerian adenosarcoma with sarcomatous overgrowth. This 75-year old woman presented with atypical vaginal bleeding and enlarged uterus. On ultrasonography the endometrium was described as "thick" (4 cm) with cysts and aggregates of sarcomatous cells were seen on VABRA curettage. TAH & BSO was performed. The polypoid intrauterine mass measured 10 cm in the largest size and protruded through the external orifice. It was yellow with scattered cysts at the base and hemorrhagic at the apex. Myometrial invasion was evident. Microscopically most of the tumor consisted of a fibrosarcoma like tissue. It contained rhabdomyoblastic elements and mitosis count was 15 or more for 10 HPF. A small part of the tumor shared the features of mullerian adenosarcoma with glands surrounded by condensed stroma. The pseudostratified glandular epithelium was ciliated and focally mucinous. Periglandular tissue was pleiomorphic and mitotically active. Immunohistochemically stromal cells showed a slight positive staining for vimentin and a strong positivity for smooth muscle specific alpha actin. With the exception of scattered cells, desmin and striated muscle specific actin were extensively negative.

Aged↗
PubMed1991

Uterine müllerian adenosarcoma with histiocytic (xanthomatous) mesenchymal component.

We present an endometrial Müllerian adenosarcoma in which the sarcomatous component showed prominent nests of foamy cells that accounted for 50% of the neoplastic mesenchyma. Such foamy cells showed occasional cytological atypias and immunohistochemical features of histiocytic (macrophagic differentiation in the absence of changes that could substantiate the presence of an inflammatory infiltration of foamy histiocytes. These facts suggest histiocytic differentiation from neoplastic mesenchymal cells. Such differentiation has been reported in association with malignant mixed mesodermal tumor, but not in Müllerian adenosarcoma.

Biomarkers, Tumor↗
PubMed1977

Adenomyoma: a precursor of extrauterine Müllerian adenosarcoma?

One patient had an extrauterine pelvic Müllerian adenosarcoma that recurred on multiple occasions and was originally diagnosed as a benign lesion. Caution is needed in the initial interpretatrion of such lesions as "adenofibromas." We have compared this lesion with a benign adenomyoma of the uterus from a second patient and suggest that such benign neoplasms serve as precursors for Müllerian adenosarcoma in some cases. Light and electron microscopic observations in the first case as well as data from the literature support this hypothesis.

Adult↗
PubMed1988

[Müllerian adenosarcoma of the uterus].

Histologic structure of Mueller's adenosarcoma has been studied in 5 patients subjected to uterine and its appendages extirpation. Microspectrophotometric assessment of the course of nuclear DNA accumulation, measurement of X-chromatin in two morphologic components of the tumor (epithelial and stromal) confirmed malignant morphological nature of the latter and benign one of the former. Basing on their experience with the 5 patients three of which died in the course of 5 years of relevant metastases, the authors believe the prognosis for uterine adenosarcoma to be poor.

Aged↗
PubMed1980

Müllerian adenosarcoma of uterine cervix. Report of a case with rapidly fatal outcome.

Müllerian adenosarcoma of the uterus has been regarded as a neoplasm of low-grade malignancy; notwithstanding frequent local recurrences, sometimes after long intervals, the overall prognosis of the three dozen or so tumors reported in the literature has been good. This report documents an unusual clinical course of an adenosarcoma of uterine cervix occurring in an 80-year-old patient. Following clinically disease-free period of 25 months after hysterectomy, the tumor recurred in vaginal vault, grew with devastating rapidity, and proved fatal within 4 months. At autopsy, massive sarcomatosis peritonei and discrete tumor nodules involving the stomach and bowel were found.

Aged↗
PubMed1984

[A case of Müllerian adenosarcoma of the uterus].

A case of Müllerian adenosarcoma of the uterus is reported. This is a low-grade malignant tumor situated between fibroadenomas and carcinosarcomas in the mixed mesodermal tumors. A 69-year-old woman complaining of an abdominal mass, underwent surgical resection of a tumor of the uterus. The tumor was divided into two parts, i.e. polypoid tumor in the endometrial cavity and nodular tumor in the myometrium. The 2 tumor types showed continuity. Microscopically, it was a so-called mixed tumor consisting of a glandular element of benign epithelial cells and an undifferentiated sarcoma; it was diagnosed as adenosarcoma.

Aged↗
PubMed1993

[Müllerian adenosarcoma. Apropos of a case].

Müllerian adenosarcoma is an uncommon disease of the female genital tract with a special place among mixed müllerian tumors because of its slow and more favorable clinical course. This tumor is composed of a benign epithelial contingent and a sarcomatous one. A case of Müllerian adenosarcoma clinically characterized by an atypical outset is described and the literature is reviewed.

Endometriosis↗