Adenosarcoma Mulleri Associated with Tamoxifen use after Breast Cancer Therapy: A Case Report

Abstract

Abstract The term ‘mixed Mullerian tumour’ applies to uterine tumours composed of epithelial and mesenchymal elements of Mullerian origin. These neoplasms are classified into adenomyomas, adenofi bromas, adenosarcomas, and carcinosarcomas (malignant Mullerian mixed tumours) based on whether the epithelial and stromal elements are benign or malignant. Adenosarcomas are low-grade neoplasms classified halfway along the spectrum of mixed Mullerian tumours, with adenofi bromas at one end and carcinosarcomas (malignant Mullerian mixed tumours) at the other. Adenosarcoma is a mixed Mullerian tumour composed of benignappearing but neoplastic glandular elements and a sarcomatous stroma, which is usually low grade. Histologically, there are heterologous mesenchymal elements (usually rhabdomyosarcoma, but also cartilage, fat, and other elements) in 20-25% of cases. We have observed that some women with these tumours have received tamoxifen treatment for breast cancer or have a history of radiation therapy. We herein report the case of a 46-year-old patient who was hospitalized at OGC CC Kragujevac because of excessive bleeding from the uterus. The patient had undergone right mastectomy three years earlier for breast cancer. After surgery, she had received Nolvadex (tamoxifen) treatment. Exploratory curettage was performed, and then, a classic abdominal hysterectomy with bilateral adnexectomy was completed. The histopathological findings indicated adenosarcoma Mulleri; therefore, the patient received postoperative radiation therapy according to our current protocol.