MULLERIAN ADENOSARCOMA OF THE UTERUS - CLINICOPATHOLOGIC REPORT OF 5 CASES

The clinicopathologic features of 5 cases of mullerian adenosarcoma of the uterus are presented and compared with those of previously reported cases. 4 tumors were localized in the endometrium; in one case, a cervical or endometrial origin was not clear. The ages of the patients ranged from 53 to 79 years. 2 died without clinical evidence of recurrence 19 and 18 years after hysterectomy. One was alive and well 10 years postoperatively and one was lost to follow-up 6 months after therapy. In one case, a first abdominal recurrence was resected 5 years and 9 months after hysterectomy; the patient died of a second abdominal recurrence 18 months later. The tumors were bulky polypoid masses producing metrorrhagia. Histologically, a sarcoma component was intimately associated with benign epithelium of various mullerian types. The neoplasm was typically organized in papillary fronds and periglandular sarcomatous cuffs. Cystic glands were also a constant feature. Mitoses were generally fewer than 10 per 10 high-power fields, except in one case where they were 44 in a more malignant-appearing area. Adenosarcoma must be differentiated from other mullerian tumors, mainly carcinoma whose prognosis is much less favorable.