Systemic therapy in advanced uterine adenosarcoma with sarcomatous overgrowth

Müllerian adenosarcoma is an uncommon biphasic tumor composed of malignant stromal and benign epithelial components. Morphologically, adenosarcoma is characterized by a broad leaflike architecture, reminiscent of phyllodes tumors of the breast. Periglandular cuffing of the stromal cells around the compressed or cystically dilated glands is characteristic. The mesenchymal component is typically a low-grade spindle cell sarcoma, whereas the epithelial counterpart is commonly endometrioid with frequent squamous or mucinous metaplasia and may, in some circumstances, show mild to moderate atypia. In all cases, it is important to assess for the presence of sarcomatous overgrowth and myometrial invasion, which are the prognostic factors. In this brief review, we present the clinical, histopathologic, and immunohistochemical features of adenosarcoma, as well as updates on the molecular biology of this neoplasm.

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“…13,30,31 CONCLUSION Müllerian adenosarcoma is a relatively uncommon entity in gynecologic pathology that has distinctive clinical and …”

Section: Treatmentmentioning

confidence: 99%

Uterine Adenosarcoma

Pinto

Howitt

2016

Archives of Pathology &Amp; Laboratory Medicine

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“…In a paper presented at the USCAP 2018 conference, Stout et al found immunoexpression of PTEN (70%), TERT (90%), PMS2 (100%), and Beta-catenin (60%); compared with low-grade endometrial stromal sarcoma, the latter also expresses the aforementioned antibodies in variable percentages, but is distinguished by finding rearrangement of the JAZF1 gene by fluorescent in situ hybridization (FISH), not being found in any case in UA; in our case, in addition to the traditional markers, we found expression of PMS2, Beta-catenin, and h-TERT. Alterations in the TP53 signaling pathway have been reported to be related to nuclear atypia and marked pleomorphism identified at lower magnification; Furthermore, the expression of the p53 protein by immunohistochemistry correlates mostly with the mutation of the gene ( 16 ). We clarify that the case was not studied molecularly, firstly because we do not have access to molecular techniques to study the tumor, and secondly because it does not provide greater benefit to choose medical therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of choice is surgical, performing total abdominal hysterectomy or by laparoscopic approach, with or without bilateral salpingo-oophorectomy; in women of reproductive age, a myomectomy and polypectomy may be chosen. There is no standardized chemotherapy, hormonal therapy, or radiation therapy in UA, due to the small number of patients with this neoplasia; however, standardized chemotherapy for uterine sarcomas, such as doxorubicin, ifosfamide, or gemcitabine/docetaxel, and newer drugs, such as trabectedin, appear to have some efficacy in UASO ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Survival rates range from 60% for tumors with myoinvasion, and <50% present metastasis. The pelvis or abdominal cavity is the first site of recurrence, and sarcomatosis is a frequent complication; distant metastases are less common, with the liver and lung being the most frequent sites, followed by bone, kidney, spleen, and rarely, brain ( 1 , 10 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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“…Four of these six patients had adenosarcomas with sarcomatous overgrowth [ 1 ]. Schroeder et al described a systemic therapy in advanced uterine adenosarcoma with sarcomatous overgrowth [ 6 ]. Tissue with sarcomatous overgrowth can be detected by immunohistochemical analysis, while the differentiation between adenosarcomas without sarcomatous overgrowth and benign adenofibromas can be difficult.…”

Section: Case Presentationmentioning

confidence: 99%

Submucous uterine adenosarcoma—minimally invasive treatment

Krentel

Wilde

2016

World J Surg Onc

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BackgroundUterine adenosarcomas are rare malignant gynaecological tumours. Due to its submucous localization, they can be easily confound with benign tumours like endometrial polyps or submucous myomas. However, the treatment of uterine adenosarcomas requires an oncologic surgical approach.Case presentationIn the following case report, we present the minimally invasive treatment of a uterine adenosarcoma by hysteroscopy and laparoscopy in a 37-year-old patient and discuss the special role of hysteroscopy in such cases.ConclusionsIn case of unknown or suspect intrauterine tumours, a diagnostic and operative hysteroscopy with biopsy could be realized prior to laparoscopic hysterectomy especially when the use of a laparoscopic electric morcellation is planned. Thus, a correct oncologic approach can be guaranteed if an adenosarcoma is diagnosed.Trial registration ISRCTN

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Systemic therapy in advanced uterine adenosarcoma with sarcomatous overgrowth

Cited by 5 publications

References 3 publications

Uterine Adenosarcoma

Uterine Adenosarcoma

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

Submucous uterine adenosarcoma—minimally invasive treatment

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