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 nulliparouswoman
has ahistory 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.
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.
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
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.
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.
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
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