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. 2012:2012:358302.
doi: 10.1155/2012/358302. Epub 2012 Aug 16.

Mullerian adenosaroma of the cervix with sarcomatous overgrowth and heterologous elements presenting as a recurrent cervical polyp

Slim Charfi  1 , Rim Kallel, Hela Mnif, Sameh Ellouze, Mohamed Dhouib, Mohamed Guermazi, Abdelmajid Khabir, Tahya Sellami-Boudawara
Affiliations

Mullerian adenosaroma of the cervix with sarcomatous overgrowth and heterologous elements presenting as a recurrent cervical polyp

Slim Charfi et al. Case Rep Obstet Gynecol. 2012.

Abstract

Mullerian adenosarcoma of the cervix is a rare tumor composed of benign epithelial and malignant stromal components. Sarcomatous overgrowth and heterologous elements in cervical adenosarcoma are extremely infrequent. We report the case of a 26-year-old woman admitted at the gynaecology department for a painless mass protruding from her vagina. The initial pathological exam concluded to endocervical polyp. Six months later, the patient was readmitted with a recurrence of the polyp. The pathological exam demonstrated interlacing fascicles of elongated spindle cells with few mitotic activity and no glandular formation. After reviewing of the initial polyp the diagnosis of mullerian adenosarcoma was suggested. A second recurrence of the polyp was noted one month later. Histopathological exam of the recurrent polyp confirmed the diagnosis of adenosarcoma with sarcomatous overgrowth and heterologous elements. The patient was lost for follow-up. Cervical adenosarcoma with sarcomatous overgrowth and heterologous element is a rare tumor that occurs in younger age in contrast to endometrium/corpus uterin mullerian adenosarcoma. In young women with recurrent cervical polyp, mullerian adenosarcoma must be considered and should be excluded by careful histopathological exam. Sarcomatous overgrowth and myometrial invasion are the most important prognostic factors. Treatment strategy is still unclear.

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Figures

Figure 1
Figure 1
interlacing fascicles of elongated spindle cells with no glandular formations.
Figure 2
Figure 2
Endocervial glands surrounded by a cellular stroma with periglandular condensation.
Figure 3
Figure 3
Irregular polypoid formation with white-grey to tan appearance. Note the presence of microcysts.
Figure 4
Figure 4
adenosarcoma with phyllodes-like appearance and dense periglandular stromal condensation.
Figure 5
Figure 5
Cartilaginous foci in adenosarcoma.
Figure 6
Figure 6
Adenosarcomatous overgrowth area in adenosarcoma: Stromal cells are large and pleomorphic.
See this image and copyright information in PMC

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