Diagnosis and management of Müllerian adenosarcoma of the uterine cervix

Abstract

Clinical diagnosis of Müllerian adenosarcoma of the uterine cervix may be challenging owing to the benign gross appearance of the cervical polyps. Surgery provides a good chance of cure with no recurrence.

Case Report of Successful Childbearing after Conservative Surgery for Cervical Mullerian Adenosarcoma

“…Therefore, therapeutic options for cervical MA patients who desire to preserve their fertility are still unknown. Until now, there have been only rare cases of women who desire fertility-preserving surgery and undergo successful treatment via local excision [4, 13–15]. These reports suggest that fertility-preserving surgery may be an alternative for patients with pedunculated cervical polypoid tumors with disease-free stalks [5, 16].…”

Mullerian adenosarcoma of the cervix: case report

“…6,24 Mean age of cases reported worldwide has been 33±18 years. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]24 Extensive literature review shows that the most common modes of clinical presentation are irregular menstrual bleeding (41%), painless mass in the introitus (41%), postmenstrual bleeding (7%), urinary retention (7%) and postcoital bleeding and vagina discharge (3% each). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]24 Our patient presented with feeling of a mass in the introitus and irregular bleeding per vaginam.…”

“…The occurrence of heterologous differentiation, as seen in our case, has been about 69% and mostly as cartilage, bone and skeletal muscle. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Such heterologous elements, usually cartilaginous, as seen in this case, may also be seen in adenofibroma, carcinosarcoma and embryonal rhabdomyosarcoma (ERMS). Like ERMS MAs may show cambium-like disposition but phyllodes-like histology seen in MA is not present in ERMS.…”

“…Treatments given have included hysterectomy, with or without bilateral salpingo-oophorectomy, with or without pelvic lymph node clearance and with or without adjuvant chemo-and/ or radiotherapy. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, the underlying principle of management is to prevent recurrence and/or metastasis. In staging the disease it is our opinion that there may be need to carry out endometrial curettage, vaginal biopsy as well as exploratory laparotomy to exclude spread to other tissues because of their anatomical contiguity.…”

“…These tumours may affect any age group including children. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Mullerian adenosarcomas (MA) account for about 8% of all uterine sarcomas. 6 In Nigeria, even though Omoniyi-Esan et al 21 have reported 2 cases of pure sarcomas over a ten year period, our report, from available literature, is the first for MA in the country.…”