Diagnostic challenges: low-grade adenosarcoma on deep endometriosis

Abstract

BackgroundMüllerian adenosarcoma is a rare malignancy. These tumors occur mainly in the uterus, but also in extrauterine locations, usually related to endometriosis. Because of their rarity, there is limited data on optimal management strategies.Case presentationWe present a 44-year-old woman with a history of endometriosis who consults for chronic pelvic pain. In the imaging tests, a heterogeneous mass is observed that impresses endometriosis, encompassing the uterus and left appendage. Surgery is performed by finding an extrauterine adenosarcoma that affected the uterus, ovary and bladder wall.ConclusionThis is a rare case but should be considered in a patient with atypical clinical characteristics or preoperative pathology, so we show the diagnostic and therapeutic strategies carried out for the resolution of the case.

Rare Mullerian adenosarcoma of the uterine cervix arising on a background of endometriosis: A diagnostic challenge with risk of malignant transformation—A case report and review of the current literature

“…The presence of a tumor stalk was found to be a protective factor in a retrospective study of both uterine and cervical adenosarcomas. 7 Case reports of adenosarcoma of the uterine cervix have described a range of tumor grades, from low grade with mild atypia and low mitotic rates 10,19 to high grade sarcomatous overgrowth. 9,20,21 The rarity of adenosarcoma of the uterine cervix makes it difficult to assess the most common presentation and it is a challenge to determine the best treatment options.…”

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 ]. In this study, it is rare that one patient had tumors in the uterine cavity and cervix simultaneously.…”

Endometriose e sua relação com o câncer de ovário: uma revisão integrativa

“…Endometriose também pode mostrar transformação maligna em neoplasias estromais mistas e epiteliais ou exclusivamente estromais, incluindo sarcoma estromal endometrial, adenocarcinoma de células claras e adenosarcoma com componentes heterólogos de rabdomiossarcoma e adenosarcoma ovariano com rabdomiossarcoma. Jimenez et al (2019), relataram um caso de adenosarcoma com baixo grau de localização extrauterina e com acometimento da parede uterina, ovário e vesical, o objetivo do artigo foi relatar um caso de adenosarcoma extrauterino que é uma patologia de baixa incidência, sendo que se acredita que os tumores extrauterinos surjam de depósito de endometriose. O caso relatado consiste em histórico de endometriose profunda, em acompanhamento há 3 anos.…”