Mullerian adenosarcoma of the cervix: Report of two large tumors with sarcomatous overgrowth or heterologous elements

Seagle, Brandon Luke L.; Falter, Keith J.; Lee, Stephen J.; Frimer, Marina; Samuelson, Robert; Shahabi, Shohreh

doi:10.1016/j.gynor.2014.04.005

Cited by 15 publications

(25 citation statements)

References 17 publications

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“…We also found that HE was a risk factor for disease progression and that the HE was striated muscle sarcoma differentiation in our study. Our findings are consistent with others in that HE, in particular striated muscle sarcoma differentiation, of the cervical adenosarcoma may be a more aggressive histologic type [15].…”

Section: Discussionsupporting

confidence: 93%

Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

Yuan

Cao

et al. 2019

The Oncologist

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Background The management of adenosarcoma is based on the limited available data. This study aimed to explore the characteristics and oncologic outcomes of patients with uterine and cervical adenosarcoma. Materials and Methods A total of 21 and 32 cases of cervical and uterine adenosarcoma, respectively, were retrospectively reviewed in Peking Union Medical College Hospital between April 2006 and March 2019. Results The median follow‐up time was 37.5 months (range, 1–153 months). The disease progression rate (DPR) was significantly higher in patients with uterine adenosarcoma compared with those with cervical adenosarcoma (28.1% vs. 4.8%). The curve of progression‐free survival significantly differed. For those with cervical adenosarcoma, the presence of a tumor stalk was a protective factor, whereas heterologous elements (HE) presented a risk factor for disease progression. For those with uterine adenosarcoma, the presence of a tumor stalk was an independent protective factor, whereas lymphovascular space invasion (LVSI) was an independent risk factor for disease progression. Moreover, HE was an independent risk factor for mortality. Fertility‐sparing surgery (FSS) was performed in four and five patients with cervical and uterine adenosarcoma, respectively. Regarding FSS, combined with cases in previous studies, the DPR of patients with uterine adenosarcoma was relatively higher compared with those with cervical adenosarcoma. Conclusion We found that cervical adenosarcoma had a better prognosis than uterine adenosarcoma. The presence of a tumor stalk was a protective factor, whereas HE and LVSI were risk factors for prognosis. For those with uterine adenosarcoma, if FSS was administered, robust evaluation would be necessary. The small sample size limits the ability to make any strong conclusions about FSS. Implications for Practice Uterine cervical adenosarcoma had a better prognosis than uterine adenosarcoma. For patients with cervical adenosarcoma, the presence of a tumor stalk was a protective factor and the presence of heterologous elements (HE) was a risk factor for disease progression. For those with uterine adenosarcoma, the presence of a tumor stalk was a protective factor and lymphovascular space invasion was a risk factor for disease progression. Moreover, HE was a risk factor for mortality. Regarding fertility‐sparing surgery (FSS), the disease progression rate was higher in patients with uterine adenosarcoma compared with those with cervical adenosarcoma. For patients with uterine adenosarcoma, if FSS was administered, hysteroscopy and robust imaging evaluation would be necessary.

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Section: Discussionsupporting

confidence: 93%

Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

Yuan

Cao

et al. 2019

The Oncologist

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“…Of these features, sarcomatous overgrowth and deep myometrial invasion are thought to be the most important adverse prognostic factor [6, 12, 13]. MAs with sarcomatous overgrowth are reported in approximately 33% of uterine corpus MAs and approximately 60% of those cases relapsed [1].…”

Section: Discussionmentioning

confidence: 99%

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

Kanayama

Nakamura

et al. 2017

Case Reports in Obstetrics and Gynecology

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Mullerian adenosarcoma (MA) is a rare tumor variant with low malignancy potential and is reported to account for 8% of all uterine sarcomas. Cervical MAs are reported to occur in relatively younger patients with the mean age of 27 years, while those in the uterine corpus generally present in postmenopausal women. Due to the rarity of cervical MAs, optimal management for these patients (especially younger women) is still under exploration. Here, we describe a case of cervical MA in a woman of reproductive age who was treated by fertility-preserving surgery and successfully delivered a child 18 months later.

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“…Recurrence developed in 4 of the 5 (80%) patients with sarcomatous growth, 3 of whom presented with myometrial invasion [13] . Table 1 lists the cases of Müllerian adenosarcoma of the cervix with sarcomatous overgrowth and other risk factors that have been reported in the English literature [16] , [17] , [18] , [19] , [20] .…”

Section: Discussionmentioning

confidence: 99%

Müllerian adenosarcoma of the uterine cervix with sarcomatous overgrowth: A case report of aggressive disease in a young patient

Morales

Medina

Trujillo

et al. 2016

International Journal of Surgery Case Reports

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Mullerian adenosarcoma of the cervix: Report of two large tumors with sarcomatous overgrowth or heterologous elements

Cited by 15 publications

References 17 publications

Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

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

Müllerian adenosarcoma of the uterine cervix with sarcomatous overgrowth: A case report of aggressive disease in a young patient

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