Department of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea
© 2017 The Korean Society of Pathologists/The Korean Society for Cytopathology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
No potential conflict of interest relevant to this article was reported.
Case No. (ref No.) | Clinical feature | Pathology | Treatment | Outcome | Remarks |
---|---|---|---|---|---|
1 [15] | Age: 51 yr | Size: 4 cm | Unknown | Unknown | - |
Gyn hx: unknown | Location: lateral wall of the uterine body | ||||
Clinical sign: unknown | Micro: | ||||
Glands with no epithelial cell atypia | |||||
Sarcomatous component with cell pleomorphism and a high mitotic count | |||||
Accompanied by adenomyosis | |||||
Tumor marker: unknown | |||||
2 [13] | Age: 20 yr | Size: unknown | Hysterectomy | Two years after surgery, no evidence of recurrent disease | Stromal overgrowth |
Gyn hx: null | Location: right anterolateral portion | ||||
Clinical sign: a longstanding history of menorrhagia and vaginal bleeding | Micro: | ||||
Florid adenomyosis with extensive myometrial invasion, expansile growth within the myometrium, and intravascular invasion in the myometrium | |||||
Tumor marker: β-hCG 50–80 mIU/mL | |||||
3 [2] | Age: 46 yr | Size: unknown | Myomectomy | Unknown | - |
Gyn hx: para 1 | Location: subserosal mass arising from the posterior surface of the uterus | Additional TAH, BSO, and bilateral pelvic lymphadenectomy | |||
Clinical sign: vaginal bleeding | Micro: | ||||
Adenomyoma with focal predominant endometrial stroma and periglandular cuffs | |||||
Endometrial stromal cells in the periglandular cuffs showing mild and focal moderate cytological atypia with sparse mitotic figures, including an occasional atypical form | |||||
Tumor marker: unknown | |||||
4 [5] | Age: 38 yr | Size: 1.5 cm | Exploratory laparotomy, TAH, LSO, and omentectomy | Disease-free 30 mo after treatment | Heterologous element (rhabdomyosarcoma) |
Gyn hx: gravida 1, para 0 | Location: right cornual area | Adjuvant cisplatin, ifosfamide, and mesna | |||
Clinical sign: chronic pelvic pain and dysmenorrhea | Micro: | 5,500 cGy to the abdominal wall | |||
Irregular glands with benign epithelium surrounded by a hypercellular spindle cell stroma showing rare mitoses, mild nuclear hyperchromasia, and pleomorphism | |||||
Tumor marker | |||||
CEA and AFP: normal | |||||
CA125: 45 U/mL | |||||
5 [10] | Age: 52 yr | Size: uncheckable (no distinct mass formation) | Radical hysterectomy with BSO and lymph node dissection and debulking of the pelvic mass | Unknown | Extrauterine pelvic mass (19 cm in diameter) diagnosed as adenosarcoma with rhabdomyosarcomatous differentiation and stromal overgrowth |
Gyn hx: gravida 3, para 3 | Location: uterine fundus | ||||
Peri-menopausal | Micro: | ||||
Diffuse adenomyosis with focal stromal expansion, consisting of a hypercellular proliferation of moderately atypical spindle cells with mitotic activity around benign endometrial glands and infiltrating the anterior myometrium | |||||
Clinical sign: none | |||||
Tumor marker | |||||
CA125: 258 U/mL | |||||
6 [14] | Age: 53 yr | Size: unknown | Unknown | Unknown | Developed breast carcinoma and received adjuvant chemotherapy including tamoxifen |
Gyn hx: unknown | Location: unknown | ||||
Clinical sign: unknown | Micro: | ||||
Uterine adenosarcoma following an adenomyoma | |||||
Tumor marker: unknown | |||||
7 | 7 Age: 40 yr | Size: 7.5 cm | Laparoscopically assisted TVH | No evidence of recurrence to date | This case |
Gyn hx: gravida 2, para 2 | Location: uterine fundus | Additional BSO | |||
Clinical sign: sudden-onset suprapubic pain and initial low back pain | Micro: | ||||
Dilated glandular elements and abundant, hypercellular stromal elements | |||||
Expansile growth within the myometrium with extensive myometrial invasion and focal infiltration with expansile margin into the subserosa | |||||
Focal involvement of adenomyosis | |||||
Tumor marker | |||||
CA125: 5,000 U/mL | |||||
CA19-9: 39 U/mL | |||||
β-hCG, AFP: normal |
Gyn Hx, gynecological history; hCG, human chorionic gonadotropin; Micro, microscopic findings; TAH, total abdominal hysterectomy; BSO, bilateral salpingooophorectomy; LSO, left salpingo-oophorectomy; CEA, carcinoembryonic antigen; AFP, α-fetoprotein; CA, carbohydrate antigen; TVH, total vaginal hysterectomy.