All Title Author
Keywords Abstract


Müllerian Adenosarcoma of the Vaginal Stump: A Case Report and Literature Review

DOI: 10.4236/jct.2018.911076, PP. 914-924

Keywords: Endometriosis, Vaginal Stump, Müllerian Adenosarcoma, Case Report

Full-Text   Cite this paper   Add to My Lib

Abstract:

Müllerian adenosarcomas are rare mixed tumors with low malignant potential, and occur mainly in the uterus. Primary adenosarcomas arising in vaginal endometriosis are even more rarely reported. We report a very rare case with Müllerian adenosarcoma arising from vaginal endometriosis. A 43-year-old nulliparous woman has a history of endometriosis. Due to two parallel fistulas in cervix, severe endometriosis and adenosarcoma, she has undergone radical and multiple surgeries. After the surgery, persistent vaginal vault masses were noticed, and eight resections of the polyps at vaginal stump were performed. For the first six resections, all the pathological examinations showed endometriosis. And the last two resections demonstrated vaginal adenosarcoma. Transition between Müllerian adenosarcoma and endometriosis was gradual. Finally, adenosarcoma associated with endometriosis was diagnosed from recurrent vaginal masses. To our knowledge, this report is the sixth case that primary adenosarcomas arising in vaginal endometriosis. But chemo-therapy and radiation therapy were not taken and the patient remained in a good condition throughout the 9-year follow-up period. In addition, we present a review of the literature. The diagnosis and treatment of the tumor are also discussed.

References

[1]  Zhao, X.D. and Zhang, Y. (2003) Müllerian Adenosarcoma. Foreign Medical Fascicles of Gynecology and Obstetrics, 30, 231-236.
[2]  Gallardo, A. and Prat, J. (2009) Müllerian Adenosarcoma: A Clinicopathologic and Immunohistochemical Study of 55 Cases Challenging the Existence of Adenofibroma. The American Journal of Surgical Pathology, 33, 278-288.
https://doi.org/10.1097/PAS.0b013e318181a80d
[3]  Judson, P.L. (2000) Vaginal Adenosarcoma Arising from Endometriosis. Gynecologic Oncology, 76, 123-125.
https://doi.org/10.1006/gyno.1999.5617
[4]  Anderson, J. (2001) Adenosarcoma in a Patient with Vaginal Endometriosis. Obstetrics & Gynecology, 98, 964-966.
[5]  Liu, L. and Davidson, S. (2003) Müllerian Adenosarcoma of Vagina Arising in Persistent Endometriosis: Report of a Case and Review of the Literature. Gynecologic Oncology, 90, 486-490.
https://doi.org/10.1016/S0090-8258(03)00266-X
[6]  Toyoshima, M., Akahira, J., Moriya, T., et al. (2004) Primary Vaginal Adenosarcoma with Sarcomatous Overgrowth. Gynecologic Oncology, 95, 759-761.
https://doi.org/10.1016/j.ygyno.2004.08.004
[7]  Han, X., Leng, J., Xiang, Y., et al. (2010) Vaginal Adenosarcoma Arising from Refractory Endometriosis: A Case Report. Aust N Z J Obstet Gynaecol, 50, 574-576.
[8]  Dincer, A.D., Timmins, P., Pietrocola, D., et al. (2002) Primary Peritoneal Müllerian Adenosarcoma with Sarcomatous Overgrowth Associated with Endometriosis: A Case Report. International Journal of Gynecological Pathology, 21, 65-68.
https://doi.org/10.1097/00004347-200201000-00012
[9]  Al-Jefout, M., Tokushige, N., Hey-Cunningham, A.J., et al. (2009) Microanatomy and Function of the Eutopic Endometrium in Endometriosis. Expert Review of Obstetrics & Gynecology, l4, 61-79.
[10]  Toyokuni, S. (2011) Mysterious Link between Iron Overload and CDKN2A/2B. Journal of Clinical Biochemistry and Nutrition, 48, 46-49.
https://doi.org/10.3164/jcbn.11-001FR
[11]  Bagga, R., Keepanasseril, A., Srinivasan, R., et al. (2010) Adenosarcoma of the Uterine Cervix with Heterologous Elements: A Case Report and Review of Literature. Archives of Gynecology and Obstetrics, 281, 669-675.
https://doi.org/10.1007/s00404-009-1200-3
[12]  Clement, P.B. (1989) Müllerian Adenosarcomas of the Uterus with Sarcomatous Overgrowth: A Clinical Pathological Analysis of 10 Cases. American Journal of Surgical Pathology, 13, 28-38.
https://doi.org/10.1097/00000478-198901000-00004
[13]  Cantrell, L.A. and Van Le, L. (2009) Carcinosarcoma of the Ovary a Review. Obstetrical & Gynecological Survey, 64, 673-80.
https://doi.org/10.1097/OGX.0b013e3181b8aff3
[14]  Hines, B.J., Porges, R.F., Mittal, K., et al. (2002) Use of Medroxyprogesterone Acetate in the Treatment of Müllerian Adenosarcoma: A Case Report. Gynecologic Oncology, 85, 192-195.
https://doi.org/10.1006/gyno.2002.6585

Full-Text

comments powered by Disqus