Müllerian Adenosarcoma: A Single-Centre Experience of 59 Cases of This Rare Entity

Abstract

Background and objective Müllerian adenosarcomas (MA) are rare biphasic tumors with benign epithelial and sarcomatous stromal components. There is very limited cohort study data on MA in the South Asian countries and no such study has been attempted in Pakistan. Our aim was to evaluate the clinicopathological characteristics of MA and to review the published literature on the condition. Additionally, we also analyzed the impact of various prognostic factors on the overall survival (OS) of patients with MA. Materials and methods This was a retrospective observational study performed at the Shaukat Khanum Memorial Hospital and Research Centre, Lahore from 2003 to 2020. A total of 59 histologically confirmed cases of MA were included in the study and critically reviewed. Results The mean age of the patients was 54 ±16 years, and the most common tumor location was the uterine corpus (48, 81.4%), followed by the cervix (eight, 13.6%), ovary (two, 3.4%), and vagina (one, 1.7%). Sarcomatous overgrowth (SO) was seen in 22 (37.3%) patients, and high-grade cytology was observed in 18 (30.5%) patients. Furthermore, lymphovascular invasion (LVI) was present in six (10.2%) patients, and myometrial invasion was noted in 25 (42.4%) patients. The follow-up details of 29 patients were available, and death was recorded in 13 (44.8%) patients with a median OS of three years. Conclusion MA is a rare and diagnostically challenging entity due to its wide differential diagnosis. It is essential to take note of different morphological features such as SO, cytological features, LVI, and heterologous differentiation because of their significant prognostic impact.

Unveiling the intriguing grape‐like mass: Uterine cervical adenosarcoma

“…Radiation therapy is considered for patients with advanced stages (FIGO stage II or higher) or in cases of recurrence. [1][2][3] Fertility-sparing surgery using cervical conization may be an option in select cases. Cervical adenosarcomas typically have a favorable prognosis, with most cases diagnosed at FIGO stage I and a 5-year overall survival rate of 63%-84%.…”

“…Fertility‐sparing surgery using cervical conization may be an option in select cases. Cervical adenosarcomas typically have a favorable prognosis, with most cases diagnosed at FIGO stage I and a 5‐year overall survival rate of 63%–84% 1–3 . Positive prognostic factors include low‐grade histology, no myometrial invasion or sarcomatous overgrowth, while the presence of heterologous elements indicates a worse outcome 2 .…”

“…Cervical adenosarcomas typically have a favorable prognosis, with most cases diagnosed at FIGO stage I and a 5-year overall survival rate of 63%-84%. [1][2][3] Positive prognostic factors include low-grade histology, no myometrial invasion or sarcomatous overgrowth, while the presence of heterologous elements indicates a worse outcome. 2 The differential diagnoses for adenosarcoma encompass adenofibroma, carcinosarcoma, endocervical polyp, endometrial stromal sarcoma, and rhabdomyosarcoma.…”

“…The standard and effective treatment for the majority of adenosarcoma cases is hysterectomy with bilateral salpingo‐oophorectomy. Radiation therapy is considered for patients with advanced stages (FIGO stage II or higher) or in cases of recurrence 1–3 . Fertility‐sparing surgery using cervical conization may be an option in select cases.…”