Abstract
Mullerian adenosarcomas are rare mixed tumors with low malignant potential, and occur mainly in the uterus. Primary adenosarcomas arising in vaginal endometriosis are even more rarely reported. We report a very rare case with Mullerian adenosarcoma arising from vaginal endometriosis. A 43-year-old nulliparous woman has a history of endometriosis. Due to two parallel fistulas in cervix, severe endometriosis and adenosarcoma, she has undergone radical and multiple surgeries. After the surgery, persistent vaginal vault masses were noticed, and eight resections of the polyps at vaginal stump were performed. For the first six resections, all the pathological examinations showed endometriosis. And the last two resections demonstrated vaginal adenosarcoma. Transition between Mullerian adenosarcoma and endometriosis was gradual. Finally, adenosarcoma associated with endometriosis was diagnosed from recurrent vaginal masses. To our knowledge, this report is the sixth case that primary adenosarcomas arising in vaginal endometriosis. But chemo-therapy and radiation therapy were not taken and the patient remained in a good condition throughout the 9-year follow-up period. In addition, we present a review of the literature. The diagnosis and treatment of the tumor are also discussed.
Highlights
We report a very rare case with Müllerian adenosarcoma arising from vaginal endometriosis
To the best of our knowledge, our case is the sixth case that primary adenosarcomas arising in vaginal endometriosis and it is the first case living without chemo-therapy or radiotherapy
The patient underwent a resection of vaginal neoplasm and the pathological examination demonstrated vaginal adenosarcoma arising in endometriosis
Summary
Müllerian adenosarcoma (MA) is a rare mixed and low malignant tumor of female genital system, and is a biphasic differential tumor that is composed of ad-. Müllerian adenosarcomas are rare tumors with non-specific clinical features, and this forms a circumstance that poses significant challenges to the clinical practice or even delayed treatment when women presented with complaints of abdominal pain and irregular vaginal bleeding from the endometriosis postoperatively. Endometriosis has the potential to develop into malignant form. The pathological feature of adenosarcoma is called “cuffing structure”, atypical hyperplasia of the cellular stromas that surround the glandular component, like dense periglandular cuffs. The aim of this report is to analyze the histological features, diagnosis and treatments of the tumor.
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