Adenosarcoma mülleriano de útero: un tumor infrecuente de difícil diagnóstico

Abstract

Uterine adenosarcoma is a rare neoplasm constituting only around 8% of all uterine sarcomas. This tumor is associated with tamoxifen therapy and pelvic radiation. The most characteristic clinical feature is a recurrent cervical polypoid lesion. Patients have often had previous biopsies for the same reason, but without an accurate diagnosis. Furthermore, a mistaken diagnosis may have been made, the most common being cervical polyp. Uterine adenosarcoma consists of neoplastic glands with a benign appearance and a sarcomatous stroma.We report the case of a 53-year-old woman with a uterine polypoid lesion. After macroscopic, microscopic and immunohistochemical studies, the diagnosis was a uterine Müllerian adenosarcoma, which is a low-grade neoplasm with good prognosis, but with a high percentage of recurrences (25%-40%).Treatment is simple hysterectomy with double adnexectomy, with the option of subsequent postoperative radiotherapy. However, because this tumor is a low-grade neoplasm, a more conservative approach has sometimes been adopted in some young patients without children.This tumor is malignant, however, and mortality from abdominal or other types of metastases has been reported. Therefore, we believe that the most appropriate and safest therapeutic option is hysterectomy.