Uterine mullerian adenosarcoma with sarcomatous overgrowth fatal recurrence within two weeks of diagnosis: a case report

Mirna H Farhat,Anwar H Nassar,Elie M Hobeika,Ghada Moumneh

doi:10.1186/1752-1947-1-103

Abstract

Mullerian adenosarcoma with sarcomatous overgrowth (MASO) is a rare variant of uterine sarcomas, associated with postoperative recurrence, metastases and a fatal outcome. The mean age at diagnosis is 54.5 years. A 37-year-old nullipara presented with irregular vaginal bleeding, a normal pelvic examination, and an initially negative ultrasound. Repeat ultrasound one month later revealed an 11-cm heterogeneous pelvic mass. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathology confirmed uterine MASO. Computed tomography 2 weeks postoperatively showed a huge mass compatible with recurrence. Patient died 2 weeks later. MASO is rarely diagnosed in women in their 4th decade. This case stresses that these aggressive tumors should be considered in the differential of patients with vaginal bleeding and pelvic masses irrespective of their age.

Highlights

Uterine sarcomas generally account for less than 4% of all uterine malignancies with the subtype adenosarcoma comprising only 8% of cases, reflecting the rarity of this entity [1]
We report a 37-year-old woman who was diagnosed with Mullerian adenosarcoma with sarcomatous overgrowth (MASO) and died within a month of diagnosis
LeFloiegwmuerpneotws1earn:dAabsiaprhcaosmicattuomusorstcrompaosed of benign epithelial Low power: A biphasic tumor composed of benign epithelial elements and a sarcomatous stroma

Summary

Introduction

Uterine sarcomas generally account for less than 4% of all uterine malignancies with the subtype adenosarcoma comprising only 8% of cases, reflecting the rarity of this entity [1]. Histology of the polypoid mass revealed a biphasic tumor composed of benign epithelial elements and a sarcomatous stroma (Figure 1). Most of these large benign cystically dilated endometrial glands were cuffed by a packed hypercellular layer of malignant stromal cells (Figure 2).

Results

Conclusion