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PubMedDate not supplied

Ascitic fluid cytology in a case of metastatic malignant mixed mesodermal tumor of the ovary.

The cytologic features of the abdominal fluid from a patient with a malignant mixed mesodermal tumor (MMMT) of the ovary are presented. Both malignant epithelial and stromal elements were cytologically appreciated and confirmed by histologic examination. Other ovarian neoplasms that can present with malignant sarcomatous elements or mixed epithelial and sarcomatous elements are discussed; this case documents the importance of recognizing these features when staging patients with unusual ovarian neoplasms. To our knowledge, this is the first complete report of the ascitic fluid cytology of an MMMT of either ovarian or uterine origin.

Aged↗
PubMed1978

Benign and low grade variants of mixed mesodermal tumor (adenosarcoma) of the ovary and adnexal region.

Eleven examples of a rare group of neoplasms composed of both epithelial and mesenchymal components are reported. Ten arose from the ovary and one arose separately in the para-ovarian region. The neoplasms are distinctive in that the stoma is more cellular than that of adenofibromas, but epithelial component is not malignant, as in carcinosarcoma and mixed mesodermal tumors, and the stoma is not sarcomatous in the low grade varieties. The 11 cases were highly variable in the cellularity and atypism of the stromal cells. The term, adenosarcoma, for these tumors is not acceptable because some were too low a grade to be regarded as sarcomas, and reports of the uterine counterpart disclose that some contain heterologous elements. For that reason, a term that will embrace the full spectrum of changes in the stroma--benign through sarcomatous--is needed. We propose that they be regarded as variants of mixed mesodermal tumor so that both the benign neoplasms and low grade sarcomas can be accommodated under one designation. Of the 11 cases, five lowest grade examples were all confined to the ovary and did not recur after surgical excision, but some of these were borderline in malignancy and probably would have progressed if untreated. Two of the 3 intermediate grade neoplasms extended beyond the ovary but were arrested by surgical excision. The 3 highest grade neoplasms were overly sarcomatous. One of these extended beyond the ovary but was arrested by combination chemotherapy. The para-ovarian adenosarcoma (also high grade) metastasized and proved fatal.

Adenofibroma↗
PubMed1980

Malignant mixed mesodermal tumor of the ovary.

Mixed mesenchymal and epithelial tumors are highly malignant neoplasms most commonly found in the uterus. Rarely, histologically identical tumors occur in the ovary. We report a 70-yr-old woman with a malignant mixed Müllerian tumor of the ovary. The tumor contained heterologous foci of immature cartilage and striated muscle, in addition to carcinosarcomatous areas. Postoperative chemotherapy was administered, but she died within 5 mth with recurrent and metastatic tumor. A review of the literature concerning extrauterine malignant mixed Müllerian tumors is added.

Age Factors↗
PubMed1983

Malignant mixed mesodermal tumors and carcinosarcoma of the ovary: report of eight cases and review of literature.

Eight cases of malignant mixed mesodermal tumors and carcinosarcoma of the ovary from our files and 193 cases from the literature were reviewed. An attempt is made to analyze these cases in regard to clinical feature, treatment results, and their outcome. A detailed review of the histogenesis is presented. These tumors grow very rapidly and are usually in advanced stages when diagnosed. Most patients are postmenopausal. Surgery, radiation therapy, and chemotherapy, either alone or in combination, have been used to treat this neoplasm, but 77.6 per cent of the patients are dead of their disease within 1 year. Limited data suggests that patients treated with surgery and combination chemotherapy survive longer. However, further investigation in finding new combination therapy is desired.

Aged↗
PubMed1985

Malignant mixed mesodermal tumor of the ovary: a report of 22 cases.

Clinicopathologic data are presented for 22 cases of malignant mixed mesodermal tumors of the ovary of both homologous and heterologous types. The results substantiate previous reports of low parity in the almost exclusively postmenopausal women with this tumor. Symptoms were the same as for ovarian malignancy in general. More than half the patients presented with stage III or IV disease, according to the International Federation of Gynecology and Obstetrics (FIGO) classification. Only four (19%) of 21 patients were alive at 18 months and had survived from three to more than 13 years. Their survival was associated strictly with stage I or II disease and with the purely homologous stromal pattern. Two tumors were contiguous with remnants of ovarian endometriosis. Differentiated malignant epithelium was most often of the serous/endometrioid type, frequently with squamous zones, and was of the mucinous type in only one case. Whereas spindle cell stroma was present in many tumors of both stromal types, atypical cartilage was the predominant heterologous element.

Adult↗
PubMedDate not supplied

Cytodiagnosis of endometrial malignant mixed mesodermal tumor.

The accuracy of endometrial aspiration smears obtained with the Isaacs cell sampler in the diagnosis of malignant mixed mesodermal tumors (MMMT) was compared to the results obtained with routine cervical and vaginal smears in five cases of MMMT found in a series of 220 endometrial aspirations. Cervical and vaginal smears previously taken on these patients were positive for adenocarcinoma or MMMT in two cases and suspicious for adenocarcinoma in the remaining three cases. Endometrial aspirates were positive for MMMT in three cases and positive for adenocarcinoma or MMMT in two cases. The endometrial aspiration smears contained a variety of cells: malignant glandular, squamous, spindly stromal, undifferentiated, osteoid and tumor giant cells; chondrocytes and free psammoma bodies were also observed. These cases indicated that endometrial aspiration can accurately detect the heterologous cellular elements found in MMMT and is an effective technique in its diagnosis.

Aged↗
PubMed1989

Pathologic complete response of advanced ovarian mixed mesodermal tumor to cisplatin, adriamycin and dacarbazine: a case report.

Presented is a case report of a stage IIIC primary ovarian mixed mesodermal tumor with gross residual disease following aggressive cytoreductive surgery. Following twelve courses of Cisplatin, Adriamycin and Dacarbazine, second-look laparotomy confirmed a pathologic complete response. The patient is now free of disease at 17+ months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Fine-needle aspiration cytology of recurrent and metastatic mixed mesodermal tumors.

We report the cytological and clinical findings of 16 fine-needle aspirates (FNAs) performed on recurrent (n = 6) and metastatic (n = 10) mixed mesodermal tumors (MMMTs). The median interval between the primary diagnosis and FNA was 16 mo. Primary sites were the endometrium (n = 11), the ovary (n = 3), the cervix (n = 1), and pelvic soft tissue (n = 1). Primary tumors showed carcinoma with homologous mesenchymal components in 13 cases and focal heterologous elements in three (two chondrosarcomas and one rhabdomyosarcoma). The FNAs showed carcinoma in all 16 cases, with adenocarcinoma differentiation in three. Mesenchymal elements were identified in aspirates of three recurrent and two metastatic lesions. They were all homologous. aspirates. We conclude that mesenchymal components in FNAs of MMMTs are less likely to be seen in metastatic lesions, and that heterologous mesenchymal components are rarely seen in these aspirates even in recurrent disease. These findings confirm that the epithelial component is responsible for the malignant behaviour of MMMTs, and suggest that these lesions may need to be classified as sarcomatoid carcinomas rather than true carcinosarcomas.

Adenocarcinoma↗
PubMed1987

Mixed mesodermal tumor of the uterus (RJ-984): case report and in vitro study.

This report describes the establishment of a cell line of a human uterine mixed mesodermal tumor. The tumor of origin derived from a hysterectomy specimen, has been maintained for 14 months in vitro and continues to grow as an established cell line. The original tumor as well as the cell line exhibited no estrogen receptors. alpha-Fetoprotein was not detected in the cultured cells or in the spent culture medium. Karyotyping revealed 46 XX chromosome complement with a balanced 11-16 translocation. This is the first documentation of such a chromosome abnormality in a genital tract carcinoma. Steroids inhibited cell growth at high (10.0 micrograms/ml) concentrations. This cell line continues to be studied and further characterized. The cell line is readily available for study of this aggressive human neoplasm.

Cell Division↗
PubMed1990

Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases.

We report on the pathologic findings in primary tumors and metastases in 203 cases of stage I and II endometrial carcinosarcoma (malignant mixed mesodermal tumor) subjected to hysterectomy and staging laparotomy. Metastases were studied in 40 of these cases, including 34 with positive findings in the pelvic and/or para-aortic lymph nodes. Features of the stromal component of the primary tumors, including grade, mitotic index, and the presence and types of heterologous elements, showed no relation to the presence of metastases at operation. High-grade, serous, and clear cell carcinomatous components, on the other hand, were associated with a higher frequency of metastases, as were deep myometrial invasion, lymphatic or vascular space invasion, and involvement of the isthmus or cervix. The current concepts of histogenesis and differentiation of these tumors are discussed, and the suggestion is made that they might represent metaplastic carcinomas.

Carcinosarcoma↗
PubMed1988

Malignant mixed mesodermal tumors of the ovary. A report of 13 cases.

The surgical pathology files at Thomas Jefferson University Hospital (TJUH) were reviewed for the period 1973-1984. Thirteen cases of primary ovarian malignant mixed mesodermal tumor (MMT) were found; however, material from only seven of these cases could be obtained for repeat review. No conclusions can be drawn regarding any impact on survival based on the histology. Treatment was highly varied reflecting the mix of physicians rendering treatment and the range of modalities used. Overall, survival was miserable. Six of the 13 patients (46.2%) survived 6 months or less, 10 of the 13 (76.9%) survived 12 months or less. No particular treatment modality seemed to offer enhanced survival unless aggressive cytoreductive surgery was performed. A plea is made for national cooperative groups to develop treatment protocols for this aggressive ovarian cancer.

Adult↗
PubMed1978

Mixed mesodermal tumor and clear cell carcinoma arising in ovarian endometriosis.

A case is reported of clear cell carcinoma, arising as several papillary masses from the lining of an endometrial cyst within the ovary, associated with a mixed mesodermal tumor arising in the stalk of the largest papillary nodule. The origin of this tumor from within a focus of endometriosis lends support to the theory that both the epithelial and mesodermal components are of Müllerian (Paramesonephric) origin.

Adenocarcinoma↗
PubMed1989

Platinum-based combination chemotherapy for malignant mixed mesodermal tumors of the ovary.

Although considerable clinical data are available to guide treatment decisions for patients with ovarian epithelial malignancies, therapy for the rare malignant mixed mesodermal (mullerian) tumor (MMMT) of the ovary is poorly studied. Ten untreated patients diagnosed with primary ovarian MMMT were managed with cis-platinum-based combination chemotherapy from 1980 to 1985. Six of the 10 patients were stage III suboptimal with evaluable residual disease; 4 of these 6 had CRs with a median duration of response of 13 months. The remaining 2 patients had PRs, of 2 and 11 months duration. Four patients had stage III optimal disease; 1 progressed at 7 months, 1 progressed at 16 months and the other 2 patients have no clinical evidence of disease at 12+ and 22+ months. Despite impressive initial response rates, survival overall was poor, with a median survival for all 10 patients of 16+ months.

Adult↗
PubMedDate not supplied

[Mixed mesodermal tumors of the uterus. Clinico-pathologic characteristics of 23 patients].

The clinical and pathological features, histogenesis and treatment of 23 cases of mixed mesodermal tumours of the uterus (15 benign and 8 malignant) in woman aged from 27 to 78 years (mean 51.25) are reviewed. The tumours manifested by non-specific symptoms, most often uterine bleeding, arising suspicion of malignancy in only two cases. Unlike malignant mixed mesodermal tumours, differentiation of adenofibromas from low-grade adenosarcomas was often very difficult, and needed careful pathohistological analysis of extirpated tissues, including all available histochemical, immunohistochemical and EM procedures. Two cases of adenofibromas recurred as adenosarcomas after four months and five years respectively. Poor prognosis of malignant variants of mixed mesodermal tumours and their difficult differentiation from adenofibromas require close collaboration of pathologists and gynaecologists, implicating hysterectomy as proposed treatment and permanent clinical monitoring.

Adult↗
PubMed1990

[Malignant mixed mesodermal tumor detected by uterine inversion. Apropos of a case. Review of the literature].

The authors report the anatomoclinical observation of an 82-year old patient presenting a mixed malignant mesodermal tumour (MMMT) revealed by a uterine inversion. The histological examination revealed sarcomatous and carcinomatous lesions with zones of chondroid metaplasia infiltrating largely the myometrium. A total vaginal hysterectomy, accompanied by radiotherapy, got the better of an early local relapse. The histogenetic hypotheses of MMMTs, the particular circumstances of the tumour revelation, as well as the methods of treatment are reviewed.

Aged↗
PubMed1986

Malignant mixed mesodermal tumors of the uterus and ovary treated with cisplatin-based combination chemotherapy.

Twelve patients with malignant mixed mullerian tumors were treated with combination chemotherapy at Vanderbilt University Hospital from 1977 through 1981. Nine patients, all of whom received combination chemotherapy with hexamethylmelamine, cyclophosphamide, doxorubicin, and cisplatin (HCAP), were evaluable for response. Objective responses (all partial responses) were noted in 3 (33.3%) (response rate greater than 10% and less than 55% with 90% confidence limits), a minimal response was noted in one patient, and stable disease in four (50%) patients. Responders survived longer (calculated from the initiation of HCAP) than nonresponders (median 112 vs 19 weeks). These results are not at present statistically different from previous studies utilizing doxorubicin alone, cisplatin alone, the combination of doxorubicin and DTIC, or the combination of vincristine, actinomycin D, and cyclophosphamide.

Aged↗
PubMed1989

[Malignant mesodermal mixed tumor of the ovary with neuro-ectodermic differentiation].

A striking ovarian tumour was observed in a post-menopausal, 54-year-old woman. Most of the tumour shows histologic features of a malignant mesodermal (müllerian) mixed tumour. However, this tumour harbours a peculiar component suggesting neuroectodermal neoplasia. Histochemical and immunohistochemical studies demonstrate focal pheochromocytomatous (or paraganglionic) and ganglionic differentiations. Several types of cells could be identified: ganglion cells (NSE +, neurofilaments +), pheochromocytes or paraganglion cells (chromogranin +), Schwann cells (S 100 protein +), and neuroblastomatous elements (NSE +). This neoplastic component could be compared with compound tumours such as pheochromocytomaganglioneuroblastoma or gangliocytic paraganglioma. This type of tumour has not been reported in ovary, notably in association with a mesodermal mixed tumour. Such observation prompts us to consider tumours of somatic origin containing germ cell-type elements, with a review of the literature.

Female↗