Case Report: Uterine Adenosarcoma With Sarcomatous Overgrowth and Malignant Heterologous Elements

Abstract

A 46- year-old woman presented a uterine adenosarcoma originating in the lower uterine segment. The diagnosis was made in an endometrial biopsy and confirmed in the pathological examination of the complete surgical specimen, both identifying heterologous malignant elements. In addition, complementary immunohistochemical studies were performed. We reviewed the literature, illustrating the clinical and morphological characteristics and the differential diagnoses to be evaluated.

Mullerian adenosarcoma of the uterus with MASO: a case report of cervical adenosarcoma in a young female that never had sexual behavior

“…The incidence is low in young women, and ethnic and genetic differences may contribute to differences in the age of onset [ 4 ]. When the sarcomatous tissue component accounts for more than 25% of the total tumor volume, it is called a MASO [ 2 ]. Most adenosarcomas originate from the endometrium (including the lower uterine segment), and a small number of them originate from the endocervix (5–10%) and extrauterine sites [ 5 ].…”

“…It is a mixed tumor composed of benign epithelial and malignant stromal components [ 1 ]. It usually occurs in the body of the uterus and rarely in the ovary or cervix [ 2 ]. It has several high-risk factors, including mullerian adenosarcoma with sarcomatous overgrowth (MASO), high mitotic rate, myometrial invasion, and extrauterine metastasis [ 3 ].…”

The uterine adenosarcoma with postoperative residual in a woman treated by total abdominal hysterectomy/bilateral salpingo‐oophorectomy: A case report and review of literature

“… 29 Some series have shown the role of radiotherapy in the local control. 4 , 30 There have been some cases of uterine adenosarcoma in the English literature 29 , 31 , 32 , 33 , 34 , 35 ; these are summarized in Table 1 .…”

Next-Generation Sequencing Analysis of 3 Uterine Adenosarcomas with Heterogeneously Differentiated Genomic Mutations

“…UA, also known as Müllerian adenosarcoma [ 3 ], was defined by the World Health Organization as a mixed epithelial and mesenchymal tumor [ 4 ]. UA occurs most frequently in the uterine body, followed by the cervix, and about 1/4 showed other heterologous interleaflet components, with striated muscle differentiation being the most common [ 5 , 6 ].…”

“…The stroma is generally a low-grade uterine sarcoma, mostly endometrial stromal sarcoma [ 2 ], which may contain heterologous components, such as the skeletal muscle, cartilage, and smooth muscle, among others. However, adenosarcoma with heterologous components is rare [ 3 ], and the molecular mechanism is unclear. Two of the three UAs reported in this study had heterologous components, and the molecular changes were detected by next-generation sequencing (NGS) to understand the pathogenesis and identify diagnostic or prognostic biomarkers.…”