Summary
A case of heterologous Müllerian adenosarcoma of the uterus is presented with emphasis on morphologic differentiation, clinical course, prognosis, and treatment. This tumor was described first by Clement and Scully in 1974. Since that time 36 cases have been reported in the literature.
The neoplasm consists of benign epithelial and malignant mesenchymal elements. The latter are composed of tissue with homologous and heterologous differentiation. Our microscopic and ultrastructural studies suggested that the heterologous elements were rhabdomyoblasts with a variable degree of differentiation.
According to the literature the prognosis of Müllerian adenosarcoma is better than that of malignant mixed Müllerian tumor. The location of the tumor — whether intrauterine or extrauterine — seems to be more important as regards prognosis than the differentiation of the sarcomatous elements. The clinical course in our patient was not different from those described in the literature.
Surgical removal of the tumor remains the treatment of choice. Some authors report a better survival rate when surgical treatment is followed by radiotherapy. Chemotherapy may be useful in cases of local or distant metastasis, and in cases of incomplete excision of the tumor mass.
Zusammenfassung
Es wird über ein heterologes Adenosarkom des Uterus berichtet. Die Geschwulst besteht aus gutartigen epithelialen Strukturen und einem malignen mesenchymalen Geschwulstanteil, wobei letzterer neben homologer auch heterologe Differenzierung mit embryonalen Rhabdomyosarkomanteilen aufweist. Der Tumor wurde licht- und elektronenmikroskopisch untersucht. Die biologische Wertigkeit des Adenosarkoms, seine Stellung in der Gruppe der Müllerschen Mischtumoren und die therapeutischen Möglichkeiten werden diskutiert.
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Dietze, O., Höpfel-Kreiner, I., Scharf, O. et al. Heterologes Müllersches Adenosarkom des Uterus — ein seltener Tumor. Arch. Gynecol. 231, 75–85 (1981). https://doi.org/10.1007/BF02110027
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DOI: https://doi.org/10.1007/BF02110027