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Results for “Mixed Tumor, Mesodermal”

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PubMed2004

Malignant mixed mesodermal tumor after tamoxifen therapy for breast cancer.

BACKGROUND: The risk of tamoxifen related endometrial neoplasm has been confirmed by multiple studies. Especially rare endometrial tumors seem to develop more frequently under tamoxifen therapy. A recent analysis showed a substantially higher risk for malignant mixed mesodermal tumor (MMMT; designated in the WHO classification of female genital tract neoplasms as carcinosarcoma) in association with tamoxifen intake. CASE: We are reporting a case of a 40-year-old multiparous premenopausal woman who received tamoxifen 20 mg daily for 2 years after the surgical treatment of breast cancer and subsequent adjuvant chemotherapy. Two years after initiation of tamoxifen treatment, the patient developed an MMMT of the uterus. More than 64 months after radical hysterectomy, salpingo-oophorectomy, and pelvic lymphadenectomy, she remains recurrence-free for MMMT. Unfortunately, she developed a local recurrence of her breast cancer in 2003. After surgical treatment, she is currently being treated with anastrozole. CONCLUSION: We are reporting a rare case of a premenopausal patient who developed a MMMT within short time of tamoxifen exposure for stage I breast cancer.

Adult↗
PubMed1996

Phase II trial of hydroxyurea, dacarbazine (DTIC), and etoposide (VP-16) in mixed mesodermal tumors of the uterus: a Gynecologic Oncology Group study.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of this three-drug regimen--hydroxyurea, dacarbazine (DTIC), and etoposide (VP-16)--in patients with advanced or recurrent mixed mesodermal tumors (MMT) of the uterus who had not undergone previous chemotherapy. The study was performed as a groupwide phase II study of the Gynecologic Oncology Group. STUDY DESIGN: Thirty-three evaluable patients received hydroxyurea 2 g in divided doses on Day 1, 700 mg/m2 DTIC and 100 mg/m2 VP-16 on Day 2, and VP-16 100 mg/m2 on Days 3 and 4. Thirty-two patients were evaluable for response. Twenty-six patients had previously undergone abdominal hysterectomy and 11 had received prior radiation therapy, for whom one dose level reduction of the first course was required. RESULTS: Two patients exhibited complete response and three patients showed partial responses for an overall response rate of 15.7% (95% confidence interval: 5.3-32.8%). Seventeen of 32 patients had stable disease on therapy. Toxicity was acceptable and there were no treatment-related deaths. CONCLUSION: This regimen reveals moderate activity in patients with advanced or recurrent MMT.

Adult↗
PubMedDate not supplied

[Malignant mixed mesodermal tumor: histo- and cytopathologic correlations].

To correlate the cytopathological and the histopathological findings in uterine mixed mesodermal malignant tumor (MMMT) we have examined the cervical smear, endometrial curettage and hysterectomy specimen of a patient diagnosed with uterine tumor. The smear was stained by Papanicolaou staining and the tissue processed by routine technique and stained H&E. The original cytological diagnosis was adenosquamous carcinoma. The histopathological diagnosis was MMMT of heterologous type. A review of the smear revealed features which may orientate the diagnosis: multinucleate cells, isolated cells with cyanophilic cytoplasm, hyperchromatic nuclei and prominent nucleoli, elongated cyanophilic cells of sarcomatous origin. We conclude that the cytopathological diagnosis of the MMMT in cervical smears is very difficult. This may be sustained by the evidence of more cell types and cellular features orientating to a sarcomatous origin. The most important differential diagnosis is adenosquamous carcinoma.

Adenocarcinoma↗
PubMed2005

Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: a Gynecologic Oncology Group study.

OBJECTIVES: To determine progression-free survival (PFS) and overall survival (OS) in women with completely resected stage I or II carcinosarcoma of the uterus treated with adjuvant ifosfamide and cisplatin, and to assess the toxicity of this regimen. METHODS: Eligible patients had histologically confirmed carcinosarcoma (mixed mesodermal tumor) and no postoperative radiotherapy following complete resection for clinical stage I or II disease. They were to have adequate renal, hepatic, and hematologic functions and performance status of 2 or less. Study entry was to be within 8 weeks of hysterectomy. Patients with previous chemotherapy, or other noncutaneous malignancies, were ineligible. Ifosfamide was administered 1.5 g/m2 intravenously (IV) over 1 h and cisplatin was given 20 mg/m(2) over 15 min followed by mesna 120 mg/m2 IV bolus, then 1.5 g/m2/24 h as a continuous infusion. Initial doses (daily x 5 every 21 days x 3 cycles) were reduced by 20% (to 4 days) for myelotoxicity. RESULTS: Nine of seventy-six patients enrolled were deemed ineligible and another two who did not receive protocol treatment were inevaluable. Of the 65 evaluable patients, median age was 65 years; 50 patients (77%) were stage I and 15 (23%) were stage II. PFS and OS, respectively, were 69% and 82% at 24 months, and 54% and 52% at 84 months. Overall 5-year survival was 62%. Leukopenia was the most commonly reported, but manageable, toxicity. CONCLUSION: Adjuvant ifosfamide and cisplatin after primary surgery for stage I or II carcinosarcoma of the uterus is tolerable. In the absence of concurrent controls, the impact on PFS and OS is unclear. Pelvic relapse remains problematic.

Adult↗
PubMed1999

Malignant mixed mesodermal tumor presenting as metastatic lymph node adenosquamous cell carcinoma: a case report.

A solitary inguinal lymph node metastasis from a poorly differentiated adenosquamous cell carcinoma of unknown origin in a 52-year-old female is described. The patient was reported to have had a 2-cm palpable mass in the left inguinal area for three years. She had made regular annual clinic visits for Pap smears since the age of 45 years. Her last visit was eight months prior to a complaint of progressive abdominal distention and dull pain of three months' duration. Physical examination showed a huge pelvic mass, and ultrasound and magnetic resonance imaging of the abdomen showed a 12-cm complex solid mass on the left ovary. The patient underwent a complete excisional biopsy of the left inguinal lymph node. Frozen section pathology revealed a poorly differentiated adenosquamous cell carcinoma. Exploratory laparotomy immediately followed pathologic confirmation of malignancy of the left inguinal lymph node. Complete surgical staging including abdominal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, retroperitoneal lymph node sampling and excisional biopsy was performed for all suspicious lesions. Stage IIIC malignant mixed mesodermal tumor (MMMT) was diagnosed due to positive left inguinal lymph node metastasis. However, the retroperitoneal lymph node and intra-abdominal cavity did not show spread of the tumors, except those confined to the left ovary with adhesion to the cul-de-sac, and sole lymph node metastasis in a left inguinal lymph node. Although we could not prove that the left inguinal lymph node metastasis had been present for the three years that it was palpable without histologic confirmation, we believe that any enlarged inguinal lymph node might be the first hint of underlying malignancy in the pelvic area, lower extremities or perineal area. In cases of a poorly differentiated carcinoma of inguinal lymph nodes of unknown origin, the abdomen should be carefully evaluated.

Carcinoma, Adenosquamous↗
PubMed1993

[Synchronous growth of a mixed mesodermal tumor and an adenocarcinoma of the urinary bladder].

The case of synchronous growth of a mesodermal mixed tumour and an adenocarcinoma in the bladder is presented. This is a rare phenomenon. Mesodermal mixed tumours are malignancies with both epithelial (carcinoma) and mesenchymal (sarcoma) differentiation. The term carcinosarcoma is frequently used in the literature. In most cases the prognosis of mesodermal mixed tumours, which depends mainly on the high rate of local recurrences, is poor. Therefore, cystectomy with suprapubic urinary diversion is the treatment of choice. However, results reported in the literature show that transurethral resection of the tumour may be adequate when there is only superficial growth of mesodermal mixed tumours. Short follow-up intervals are absolutely essential for patients treated this way.

Adenocarcinoma, Papillary↗
PubMed1984

The epithelial origin of a malignant mesodermal mixed tumor of the bladder: report of a case with long-term survival.

Malignant mesodermal mixed tumors of the bladder are complex neoplasms consisting of elements of carcinoma and differentiated sarcoma. They are rare, aggressive and usually rapidly fatal. We report on a patient who remained free of disease 7 years after resection by partial cystectomy of a malignant mesodermal mixed tumor. Only 1 other long-term survivor has been reported. Our case is of particular interest because urothelial carcinoma in situ was found in the bladder epithelium on the surface and at the periphery of the invasive tumor, strongly suggesting an epithelial origin of this and similar tumors of other organs.

Carcinoma in Situ↗