uterine adenosarcoma

{{Infobox medical condition (new)

| name = Uterine adenosarcoma

| synonyms = Adenosarcoma of the uterus, Müllerian adenosarcoma of the uterus

| image = Uterine adenosarcoma - high mag.jpg

| caption = Micrograph of a uterine adenosarcoma showing a mitotically active malignant stroma and benign glands. H&E stain.

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| field = Gynecology

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Uterine adenosarcoma is an uncommon form of cancer that arises from mesenchymal tissue of the uterus and has a benign glandular component.

Signs and symptoms

The most common presentation is vaginal bleeding.{{Cite journal | last1 = Verschraegen | first1 = CF. | last2 = Vasuratna | first2 = A. | last3 = Edwards | first3 = C. | last4 = Freedman | first4 = R. | last5 = Kudelka | first5 = AP. | last6 = Tornos | first6 = C. | last7 = Kavanagh | first7 = JJ. | title = Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience. | journal = Oncol Rep | volume = 5 | issue = 4 | pages = 939–44 | year = 1998| doi = 10.3892/or.5.4.939| pmid = 9625851 }} Other presentations include pelvic mass and uterine polyp. Generally, the clinical findings are non-specific.

Pathology

Uterine adenosarcoma have, by definition, a malignant stroma and benign glandular elements. The World Health Organization (WHO) criteria have a mitotic rate cut point; however, this is often disregarded, as bland-appearing tumours with a low mitotic rate are known to metastasize occasionally.{{Cite journal | last1 = McCluggage | first1 = WG. | title = Mullerian adenosarcoma of the female genital tract. | journal = Adv Anat Pathol | volume = 17 | issue = 2 | pages = 122–9 |date=Mar 2010 | doi = 10.1097/PAP.0b013e3181cfe732 | pmid = 20179434 | s2cid = 196403103 }}

Image: Uterine adenosarcoma - low mag.jpg | Low mag.

Image: Uterine adenosarcoma - add - intermed mag.jpg | Intermed. mag.

Image: Uterine adenosarcoma - very high mag.jpg | Very high mag.

Treatment

Uterine adenosarcomas are typically treated with a total abdominal hysterectomy and bilateral salpingoophorectomy (TAH-BSO). Ovary-sparing surgery may be done in women wishing to preserve fertility.{{Cite journal | last1 = Adedipe | first1 = TO. | last2 = Vine | first2 = SJ. | title = Mullerian adenosarcoma of the uterus: a rare neoplasm with a need for onco-fertility. | journal = Eur J Gynaecol Oncol | volume = 31 | issue = 6 | pages = 714–6 | year = 2010 | pmid = 21319526 }}

Prognosis

The prognosis is determined primarily by the cancer stage. Most tumours are discovered at an early stage and have a good prognosis, especially when compared to uterine carcinosarcoma. Five-year survival for stage I and stage III tumours is approximately 80% and 50% respectively.{{Cite journal | last1 = Arend | first1 = R. | last2 = Bagaria | first2 = M. | last3 = Lewin | first3 = SN. | last4 = Sun | first4 = X. | last5 = Deutsch | first5 = I. | last6 = Burke | first6 = WM. | last7 = Herzog | first7 = TJ. | last8 = Wright | first8 = JD. | title = Long-term outcome and natural history of uterine adenosarcomas. | journal = Gynecol Oncol | volume = 119 | issue = 2 | pages = 305–8 |date=Nov 2010 | doi = 10.1016/j.ygyno.2010.07.001 | pmid = 20688363 }}

See also

References

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