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MMMTs occur in the uterus, ovaries, fallopian tubes and vagina, in descending order of frequency .
Mesenchymal tumors, including MMMTs, endometrial stromal sarcomas, mullerian adenosarcoma, leiomyosarcomas and uterine pleomorphic rhabdomyosarcomas, have been more recently described with tamoxifen use [3,9] and have a poor prognosis.
Histological examination of the endometrial curettage showed a total occupation of a malignant tumor with the characteristics of homologous MMMTs. Microscopically, the lesion was composed of an extensive biphasic tumor, consisting of solid epithelial formations.
There is a very strong association between the tamoxifen treatment and the occurrence of MMMTs of the uterine corpus.
Presentation and outcome of 3 MMMT cases diagnosed in 1 year Age Premenopausal Postmenopausal 1 2 Nature of tumor Homologous Heterologous 2 1 Lymphovascular and perineural Present Absent involvement 1 2 Extrapelvic involvement Present Absent 1 2 Surgery Done Not done 2 1(Previously hysterectomized) Chemotherapy Given Not given 3 -- Radiotherapy Given Not given 1 2 6 months survival Noted Not noted 2 1
INTRODUCTION: Malignant Mixed Mullerian Tumors (MMMTs) or carcinosarcomas are composed of malignant epithelial (carcinomatous) and mesodermal (sarcomatous) components.
(4-6,9-11) MMMTs are sub-divided into homologous and heterologous tumors.
MMMTs of the uterus arise in the endometrium and the epithelial component usually predominates.
The usual location is the uterine body, particularly the posterior wall of the fundus but a few cases with MMMT of the uterine cervix have been reported as well (8).
The characteristic microscopic features of MMMTs are the admixture of carcinomatous and sarcoma like elements resulting in a biphasic pattern.
Various muscle markers, CD (10), and HER-2/ neu also have been encountered in MMMTs (8).
The etiologic factors, involved in the development of MMMTs are not clear.
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- Mmmeri Mouloud