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At least 19 recordsLinked to original sources

PubMed1997

[Uterine adenosarcoma. Apropos of a case of uterine and vaginal adenosarcoma with a corrected genital prolapse].

Uterine adenosarcoma is an apparently benign mixed tumor with a muller type epithelial component and a sarcomatous stromal component. We present a patient with remodeled genital prolapse who developed a bifocal localization in the endometrium and vagina. These tumors are uncommon, 8% of the sarcomatous tumors of the uterus. Their usual presentation may mimic cervical or endometrial polyps. Pathology is required for positive diagnosis which evidences the two components. The diagnosis may be missed at the first examination (two-thirds of the cases in certain series). Treatment is surgical with hysterectomy in peri- or post-menopaused women and tumoral excision or curettage in younger women. The prognosis is good but can worsen if invasion extends beyond one-third of the myometrial thickness or if pure sarcomatous transformation occurs.

Adenosarcoma↗

PubMed1981

Adenofibroma and adenosarcoma of the uterus: a clinicopathologic study of 35 cases.

The clinical and histopathologic features of ten adenofibromas and 25 adenosarcomas of the uterus were studied. The most useful criterion for distinguishing adenofibroma from adenosarcoma was the frequency of mitotic figures found in the stroma. Adenofibromas had fewer than four mitotic figures per 100 HPF in the most active areas; adenosarcomas had four or more. Myometrial invasion, histologically malignant heterologous mesenchymal elements, and marked atypia of stromal cells were histologic features detected only in adenosarcoma. Of the women with adenosarcoma, ten (40%) had recurrences, with a median interval to recurrence of five years. The only morphologic feature that correlated with aggressive behavior of adenosarcoma was deep myometrial invasion. Adenofibroma and adenosarcoma are in the family of mixed mesodermal tumors, but are distinct clinical and pathologic entities.

Adenofibroma↗

PubMed1994

[Heterologous mesodermal adenosarcoma of the endocervix. Description of a clinical case].

We describe a case of an endocervical heterologous mesodermal adenosarcoma, found in a 43 year old woman. Among mesodermal neoplasms, various histological types are distinguished: the carcinosarcoma, the embryonal rhabdomyosarcoma or botryoid sarcoma, and the adenosarcoma; the last is formed by a benign epithelial component and by a malignant stromal component, that may contain heterologous tissues, such as cartilage, skeletal muscle, etc. Adenosarcoma is a tumor of the uterine corpus and seems to be most common among menopausal women. A primitive adenosarcoma of the uterine cervix is very rare; in fact the overall percentage of the uterine cervical sarcoma is 0.2-0.4%. The patient, age 43 years, with regular menstrual bleeding came to an outpatient clinic referring a post coital metrorrhagia. After a control examination, a polyp from the uterine cervix was removed; the histopathologic diagnosis was: fibroangioadenomatous polyp of the isthmus with cartilaginous metaplastic areas. Two months later, the patient was referred to our clinic and another cervical polyp was removed. The histological diagnosis was adenosarcoma with chondrosarcomatous heterologous mesodermal component. Then the patient was operated and the postoperative histological examination confirmed the preoperative diagnosis. A literature review about the uterine adenosarcoma etiopathogenesis is reported, and a suitable diagnostic iter, is discussed.

Adenosarcoma↗

PubMed1989

Extrauterine müllerian adenosarcoma of the peritoneal mesothelium: a clinicopathologic and electron microscopic study.

An unusual case of a müllerian adenosarcoma of the peritoneal mesothelium in a 32-year-old pregnant woman is described. On emergency laparotomy, a tumor was found in the pelvis connected with the right broad ligament only, and was removed. Light and electron microscopic examination showed a rare example of an extrauterine müllerian adenosarcoma composed of a stromal sarcoma, muscle tissue resembling primitive myoblasts, and sex-cord-like tubular lumens. The patient was followed, and after 22 months the primary surgery was reexplored. On laparotomy, no evidence of disease was found, and the ovaries were tumor-free. Histologic examination of the pelvic peritoneum demonstrated small areas of adenosarcoma resembling elements of the previous tumor. Müllerian adenosarcoma is a rare tumor of müllerian origin, and its less aggressive behavior as compared with mixed müllerian sarcoma is warranted. The better prognostic outlook of müllerian adenosarcoma is probably related to the histologic structure, but depends in addition on the size of the tumor and the site of origin. No case of peritoneal origin of müllerian adenosarcoma has been previously reported; we discuss this unusual location.

Adult↗

PubMed1993

Müllerian adenosarcoma presenting as cervical polyps: a report of seven cases and review of the literature.

OBJECTIVE: To emphasize the importance of early diagnosis in cases of müllerian adenosarcoma that appeared as benign-looking cervical polyps. METHODS: We examined seven cases of müllerian adenosarcoma of the uterus in patients 14-63 years of age (median 39 years). Tissue protruding from the external os and an initial diagnosis of a cervical polyp were common findings for all patients. On repeated examination, all lesions were interpreted as müllerian adenosarcomas. RESULTS: Histologic examination demonstrated benign glands with a sarcomatous stroma, which typically formed periglandular cuffs of increased cellularity. The sarcomatous stroma was homologous in four cases and contained heterologous elements such as striated muscle, lipoblast, and cartilage in three cases; one patient had a sarcomatous overgrowth of stromal elements. The question of a müllerian adenofibroma versus adenosarcoma was raised in three cases with the general appearance of slit-like glands surrounded by a stroma with fibrosis and a low mitotic rate. Using the criteria of stromal cellularity--marked stromal atypia and a mitotic index of two figures per ten high-power fields--the cases were classified as adenosarcomas. The sarcomatous overgrowth, the presence of heterologous elements, and a high mitotic rate seem to be important prognostically. CONCLUSION: Gynecologists and pathologists should be aware of the difficulties and delay in the diagnosis of müllerian adenosarcoma when the tumor presents as a benign-looking cervical polyp.

Adolescent↗

PubMed1989

Müllerian adenosarcomas of the uterus with sex cord-like elements. A clinicopathologic analysis of eight cases.

Eight cases of uterine müllerian adenosarcoma with sex cord-like elements (SCEs) occurred in patients 22-85 years of age (median, 41) who presented with abnormal uterine bleeding. Seven patients had hysterectomy; one had curettage and radiation only. The polypoid endometrial tumors were composed of adenosarcoma admixed with SCEs; the latter accounted for 5-50% of the tumor. The SCEs were multifocal in six cases and formed a solitary mass at the base of the adenosarcoma in the remaining two cases. Benign-appearing epithelial-type cells, often containing abundant eosinophilic or foamy, lipid-rich cytoplasm, were arranged in solid nests, trabeculae, and solid or hollow tubules. Myometrial invasion was observed microscopically in six cases. Of seven patients with postoperative follow-up information, six were alive with no evidence of recurrent tumor at postoperative intervals of 3-11 years. The patient treated only by curettage and radiation had persistent intrauterine tumor at 7 months and died of an unrelated illness at 16 months. This study indicates that occasional uterine adenosarcomas contain SCEs similar to those described in endometrial stromal tumors and uterine tumors resembling ovarian sex cord tumors. The clinical and pathologic features of these tumors are otherwise similar to those of typical uterine adenosarcomas.

Adult↗

PubMed1989

Müllerian adenosarcomas of the uterus with sarcomatous overgrowth. A clinicopathological analysis of 10 cases.

Ten cases of müllerian adenosarcoma of the uterus with sarcomatous overgrowth are described. The tumors were found in women 32 to 82 years of age (median, 59), most of whom presented with abnormal vaginal bleeding and an enlarged uterus. At the time of abdominal hysterectomy, performed in all the cases, bilateral ovarian and peritoneal metastases were found in one patient. Gross examination of the uterus revealed bulky polypoid masses filling the endometrial cavity. In six cases, these masses invaded the myometrium. In three of them, they reached the serosa. Histological examination in each case revealed typical adenosarcoma overgrown by a pure sarcoma that accounted for 25% to 80% of the tumor. In seven tumors, the pure sarcoma was of higher grade and exhibited a higher mitotic rate than the sarcomatous component of the associated adenosarcoma, whereas in three tumors, the two sarcomatous components were similar in appearance. On follow-up, three patients were alive with no evidence of recurrent tumor at postoperative intervals of 4 to 7 years. Recurrent tumor developed in the other seven patients, including hematogenous metastases in four of them, at intervals of 9 months to 6 years. Six patients died from tumor progression at intervals of 9 months to 10 years. This study indicates that, in contrast to typical müllerian adenosarcomas of the uterus, adenosarcomas with sarcomatous overgrowth are aggressive tumors frequently associated with postoperative recurrence or metastases and a fatal outcome.

Adult↗

PubMed1983

Uterine adenosarcoma: a clinicopathologic study of 11 cases with a reevaluation of histologic criteria.

Eleven biphasic uterine tumors with epithelial components and homologous stroma were reevaluated. Originally these were diagnosed as adenofibroma, adenosarcoma, carcinosarcoma, or mixtures thereof, but were now reclassified as adenosarcomas of which seven were "pure" and four mixed with foci of carcinosarcoma. Nine of the tumors arose in the endometrium and two in the endocervix. The mean patient's age was 55 years. The most common complaint was vaginal bleeding. Macroscopically these tumors presented as polypoid masses. The epithelial component consisted mainly of endometrial, endocervical, ciliated, and clear cells. Squamous metaplasia and focal hyperplasia were occasionally observed. Malignant epithelial change was only present in foci of carcinosarcoma. The stroma showed prominent cellular periglandular cuffs, occasionally round solid or perivascular nodules, and areas of focal or diffuse stromal hypercellularity. In all these areas stromal cells were atypical and/or pleomorphic. Stromal foam cells were seen in three cases. Mitotic activity was low ranging from one to three mitoses per 10 high power fields (HPF). Follow-up was negative exept in two cases with recurrence and abdominal metastases. It was concluded that stromal hypercellularity with atypism and pleomorphism in periglandular, perivascular location as well as of focal or diffuse nature, is characteristic of uterine adenosarcoma. Adenofibromas present a fibro-collagenous stroma lacking the crowded cellular areas. Mitotic activity is too variable to serve as a reliable diagnostic criterion. Uterine adenosarcomas are usually tumors of low grade malignancy but the lack of correlation between histologic appearance and biologic behaviour precludes prognostication in the individual patient.

Adult↗

PubMed1981

Endometrial adenosarcoma with pelvic involvement following uterine perforation.

An 85-year-old woman had a 7-year history of recurrent uterine adenosarcoma. One year after curettage-related uterine perforation, she developed a pelvic mass that was attached to the uterine serosa and was histologically identical to her endometrial lesions. The pelvic neoplasm probably resulted from implantation of tumor through the myometrial tear and is the first reported example of serosal adenosarcoma following myometrial perforation. The definition of sarcomatous stroma in Müllerian adenosarcoma, and thus its separation from adenofibroma, has not been delineated. A review of the literature indicates, however, that lesions recurring after hysterectomy have greater than three mitotic figures per 10 high-power fields. Incompletely excised neoplasms, treated by dilation and curettage only, often regrow, regardless of mitotic rate. Adenosarcoma may have a deceptively bland low-power pattern and must be differentiated from adenofibroma and benign polyps.

Aged↗

PubMed1995

Adenosarcoma of the uterine cervix: a clinicopathological study of 12 cases.

The clinical and pathologic features of 12 cervical adenosarcomas from the files of the Armed Forces Institute of Pathology are described. The patients ranged in age from 13 to 67 years (mean 37). The majority (58%) presented with abnormal bleeding. All tumors were located in the cervix and consisted of soft, tan, polypoid or papillary masses ranging in size from 1.5 to 4.5 cm. Microscopically, they showed a biphasic pattern with mesenchymal and epithelial components. There was a characteristic stromal condensation below the epithelial surface and around glandular structures. The cytologic atypia of stromal cells was 1+ in three, 2+ in five, and 3+ in four. The mitotic activity ranged from four to 28 (mean 7.0) mitotic figures per 10 high-power fields. One neoplasm contained cartilage and one striated muscle. Myometrial invasion was present in three. Treatment consisted of hysterectomy in nine patients and excisional biopsy in three. Two patients received radiotherapy; one before surgery and the other after hysterectomy. Two were treated with chemotherapy. Follow-up ranged from 9 months to 18.8 years. Nine patients were alive and well with no evidence of recurrent tumor at postoperative intervals of 0.8-18.8 years. One patient died 1 year after diagnosis with intraabdominal metastasis. One developed a recurrent tumor. This study demonstrates a favorable prognosis for patients with cervical adenosarcoma. Similar to patients with uterine adenosarcoma, prognosis is mostly affected by the presence of deep myometrial invasion.

Adenosarcoma↗

PubMed1998

Adenosarcoma of the uterine cervix presenting as a cervical polyp.

A case of adenosarcoma arising from the uterine cervix of a 55-year-old female who complained of vaginal discharge is reported. A polyp, 6 x 2 x 1.5 cm in size, identified in the cervical canal was clinically diagnosed as benign cervical polyp and resected. Histologically, the polyp was composed of benign epithelial components and sarcomatous stroma wherein periglandular hypercellularity and some mitoses including atypical ones were noted. Immunohistochemically, stromal cells were positive for muscle-type actins, desmin and estrogen receptor. Adenosarcoma is a rare, biphasic tumor of the uterus and usually presents as a polypoid mass in the endometrial cavity. When they arise from the cervix, adenosarcomas may be confused with benign cervical polyps clinically and pathologically. As the former often recurs, microscopic differentiation is crucial for further treatment.

Actins↗

PubMed1990

Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature.

One hundred cases of mullerian adenosarcoma of the uterus were encountered in patients 14 to 89 years of age (median, 58 years), who usually had the symptom of abnormal vaginal bleeding. An enlarged uterus and tissue protruding from the external os were the most common findings on pelvic examination. Five patients presented on multiple occasions with "recurrent polyps" that were interpreted retrospectively as adenosarcomas. Primary treatment, known in 97 cases, included some form of hysterectomy in 93 of them, and conservative resection in four cases. Gross examination of the excised uteri disclosed polypoid masses, some of which had spongy cut surfaces, usually filling the endometrial cavity; less commonly, the tumors were confined to the endocervix or the myometrium or involved more than one site. Histologic examination revealed benign or atypical neoplastic glands within a sarcomatous stroma, which typically formed periglandular cuffs of increased cellularity, intraglandular polypoid projections, or both. The sarcomatous stroma was homologous in 78% of the cases and contained heterologous elements in the remainder. The stromal mitotic rate varied from 1 to 40 mitotic figures (MFs) (mean 9) per 10 high-power fields (HPFs). Extensive areas of stromal fibrosis that focally imparted a deceptively benign appearance to the tumor were common. Myometrial invasion was present in 15 cases, but was deep in only four. Recurrent tumor developed in 23 cases at postoperative intervals of 0.5 to 9.5 years (mean 3.4); in one third of such cases, the interval was 5 years or longer. Recurrent tumor was almost always confined to the vagina, pelvis, or abdomen; hematogenous spread occurred in only two cases. The only feature associated with an increased risk for recurrence was the presence of myometrial invasion. Criteria found useful in separating mullerian adenosarcomas from mullerian adenofibromas included, alone or in combination: two or more stromal MFs per 10 HPFs, marked stromal cellularity, and significant stromal cell atypia.

Adolescent↗

PubMed1989

Mullerian adenosarcoma of the cervix with heterologous elements: diagnostic and therapeutic approach.

Mullerian adenosarcoma of the cervix with heterologous elements is an extremely rare tumor first described by Roth and colleagues (L. M. Roth, G. L. Pride, and H. M. Sharma, Cancer 37, 1725-1736) in 1976. Since that time there have been only three subsequent reports of these cervical Mullerian adenosarcomas, which seem to occur most often in the postmenarchal age group. Due to the paucity of cases and the unknown biological potential of the tumor, therapy has ranged from simple excision to radical pelvic surgery and vaginectomy combined with both radiotherapy and chemotherapy. We report another case of Mullerian adenosarcoma of the cervix occurring in a teenage woman and make recommendations about diagnostic and therapeutic measures available to the physician.

Adolescent↗

PubMed1992

[Adenosarcoma of the uterus].

A case of a 67-year old woman with adenosarcoma of the uterus is reported. Adenosarcoma is a mixed mesodermal tumour with a low malignant potential. It is characterised by a benign glandular and a malignant stromal component. Adenosarcomas are usually treated by hysterectomy with bilateral salpingo-oophorectomy. Patients with myometrial invasion have an increased risk of recurrence. It may be appropriate, to consider adjuvant chemotherapy or radiation treatment for these patients.

Aged↗

PubMed1985

Rhabdomyosarcomatous uterine adenosarcoma.

A case of rhabdomyosarcomatous adenosarcoma of the uterine cervix is described and the literature reviewed. This variant of adenosarcoma does not appear to be more malignant than other adenosarcomas. It can and should be differentiated from embryonal rhabdomyosarcoma and malignant mixed müllerian tumor because of the different prognostic implications and therapeutic approaches.

Child↗

PubMed1992

Adenosarcoma of the uterus: a Gynecologic Oncology Group clinicopathologic study of 31 cases.

We report on the clinical and pathologic findings in 31 cases of adenosarcoma of the uterus subjected to hysterectomy and staging laparotomy. Nine of 30 patients (30%) have had recurrent tumor and six of 30 (20%) have already died of tumor in a relatively short follow-up period (mean, 38.3 months). Seventeen of 31 cases were diagnosed as adenosarcoma with sarcomatous overgrowth (SO). Ten of these 17 with SO contained focal or extensive rhabdomyosarcoma. In six cases, extrauterine spread was identified as follows (two patients had two sites each): vaginal involvement (two cases), pelvic lymph node metastases (two), positive peritoneal cytologic findings (two), parametrial invasion (one), and ovarian metastasis (one). Extrauterine spread (stage III) (p less than 0.001) and myometrial invasion (p = 0.04) were associated with higher rates of recurrence. The presence of lymphatic and/or vascular invasion, SO, and rhabdomyosarcomatous differentiation also indicated poor prognosis but did not attain statistical significance. Based on this experience, staging laparotomy including peritoneal cytology is suggested in cases of clinical stages I and II adenosarcoma. The differential diagnosis of these tumors is also discussed.

Adult↗

PubMed1990

[Mullerian adenosarcoma].

The Müllerian adenosarcoma is an extremely rare entity of tumours of the group of the Müllerian and mesodermal mixed tumours. This tumour seems to be a malignant transformation of the uterine papillary cystadenofibroma. The periglandular malignant transformation of the stromal component and the benign glandular structures are typical signs of the Müllerian adenosarcoma. In accordance with references the prognosis of the adenosarcoma is better than those of other Müllerian mixed tumours. The demonstrated cases warn against undervalue.

Aged↗

PubMed1982

Adenosarcoma of the ovary. A light- and electron-microscopic study with review of the literature.

This is a light- and electron-microscopic study of a large ovarian adenosarcoma in a 50-year-old woman as well as a review of the literature. The tumor showed a variety of müllerian type epithelia and a spectrum of stromal patterns including nonspecific fibroblastic, and endometrial type stroma. The latter ranged from normal-appearing to low-grade sarcoma. This study emphasizes the relationship of ovarian adenosarcoma to cystadenofibroma, on the one hand, and to malignant mixed müllerian (mesodermal) tumor, on the other. It appears that the mitotic count which is used as the primary means for the classification of smooth muscle and stromal tumors of the uterus, has less value in the assessment and prognostication of ovarian adenosarcomas.

Adenofibroma↗