The FIGO (International Federation of Gynecology and Obstetrics) Staging System for Uterine Adenosarcoma
Stage Definition I Tumor limited to uterus IA Tumor limited to endometrium/endocervix with no myometrial invasion IB [less than or equal to] 50% myometrial invasion IC >50% myometrial invasion II Tumor extends beyond the uterus, within the pelvis IIA Adnexal involvement IIB Involvement of other pelvic tissues III Tumor invades abdominal tissues (not just protruding into the abdomen) IIIA One site IIIB >1 site IIIC Metastasis to pelvic and/or para-aortic lymph nodes IV IVA Tumor invades bladder and/or rectum IVB Distant metastasis Table 2.
Malignant features in epithelial component ruled out adenosarcoma
, so the diagnosis of MMMT was confirmed.
of the cervix: differential diagnosis, histogenesis and review of the literature.
of the uterine cervix presenting as a cervical polyp.
Therefore, it is important for the surgical pathologist to recognize this rare entity and differentiate it from other lesions, particularly tumors of intermediate malignant potential, such as low-grade endometrial stromal sarcoma or endometrioid carcinoma with sex-cordlike features and the highly aggressive adenosarcoma
, carcinosarcoma, and metastatic ovarian sex-cord stromal tumor by thorough sampling, use of a proper IHC panel, and awareness of the patient's complete clinical picture.
Finally, a wide range of mullerian neoplasms are know to arise in association with endometriosis, including endometrioid and clear cell carcinoma, endometrial stromal tumors, adenosarcoma
, and carcinosarcoma (54,55); these diagnostic possibilities must be excluded in cases of extensive endometriosis.
is an unusual biphasic malignancy that arises in the uterus, and less frequently, in the ovaries and peritoneum.
Review of the previous biopsy revealed low grade Mullerian adenosarcoma
without sarcomatous overgrowth.
In 2010, she was diagnosed with Adenosarcoma
, a rare type of uterine cancer.
The presence of cartilage in MMMT is considered a favorable prognostic factor.8 Uterine sarcoma accounts for 3-5% of all corpus uteri malignancies; undifferentiated uterine sarcomas arise from the endometrium or myometrium, lacking any resemblance to normal endometrium and may show heterologous stromal elements in the form of cartilage, bone or rhabdomyoblasts.9 In our case the hyaline cartilage nodules were mostly located deep in the myometrium, close to the serosal surface and adjacent tissue exhibited foci of adenomyosis; the closest differential diagnosis ruminated was adenosarcoma
have a biphasic morphology comprising of benign epithelial elements and malignant stromal elements.10
Presence of glandular differentiation may necessitate exclusion of florid endometriosis and adenosarcoma
. Presence of sex cord differentiation requires distinction from granulosa cell tumors.
is an extremely rare subtype of uterine sarcoma, which represents only 5.5 to 9% of all uterine sarcomas [1,2].