Stromal malignant sarcomatous component may be either homologous (composed of tissues normally found in the uterus) or heterologous (containing tissues not normally found in the uterus, most commonly malignant cartilage or skeletal muscle).9 The poor prognostic sign is marked pleomorphism and atypia in sarcomatous element with deep myometrial invasion.3 We excluded the possibility of adenosarcoma by performing extensive sampling of the uterus and submitting the chondroid areas completely for microscopic examination.
Mullerian adenosarcoma of the cervix with heterologous elements and sarcomatous overgrowth.
Cisplatin- and carboplatin-based regimens appear to be the least effective in uterine adenosarcomas and should not be recommended for treatment of recurrent or metastatic disease.
This suggests a benefit of doxorubicin/ifosfamide over gemcitabine/docetaxel in the treatment of uterine adenosarcomas, despite similar median OS, as patients with more aggressive disease would be expected to have worse survival.
As a result, there is no optimal management option for cervical adenosarcomas due to the rarity of this phenomenon.
Mullerian adenosarcomas of the uterus with sarcomatous overgrowth.
Mullerian adenosarcomas with unusual growth patterns: staging issues.
mixed tumors of the uterus, in which the stromal component has been malignant, but the epithelial elements, benign," and proposed naming these tumors adenosarcoma. A subsequent study, (2) in 1979, added a few cases to the original series, and the term Mullerian adenosarcoma has since become universally recognized.
TABLE 1: Staging for uterine sarcoma (leiomyosarcomas, endometrial stromal sarcomas, adenosarcomas, and carcinosarcomas).
Uterine LMS must be distinguished from other mesenchymal tumors, such as endometrial stromal sarcoma, adenosarcoma, carcinosarcoma, epithelial tumors, and dedifferentiated mixed tumors as the biology, patterns of recurrence, overall behaviors, and response to treatment are distinct from each other [8-10].
A similar type of tumor, Mullerian adenosarcoma, was first described in 1974 [19].
Hysterectomy assures complete excision, as well as permitting the thorough sampling needed to exclude the possibility of adenosarcoma. Indeed, most patients with adenofibroma underwent hysterectomy, with none showing tumor recurrence [1-14,16-18].
