Adenosarcoma
Synonyms: Müllerian Adenosarcoma
Abnormal vaginal bleeding
Quick Facts
Behaviour
Malignant
Category
Soft tissue
Grade
Variable
Synonyms
Müllerian Adenosarcoma
Category
Soft tissue
Behaviour
Malignant
Grade
Variable
Gender
Female
Tissue of Origin
Müllerian-derived tissues (Endometrium, Ovary)
Epidemiology
- Rare; 5% of uterine sarcomas
- Peak incidence 6th–7th decades, but can occur in adolescents
Clinical Features
- Abnormal vaginal bleeding
- Pelvic pain
- Polypoid mass protruding through the cervical os
Location
- Uterine corpus (most common)
- Cervix and ovaries
- Extra-uterinely in pelvic soft tissue (associated with endometriosis)
Imaging
- USS: thickened endometrium, large hterogenous mass
- MRI: polypoid mass filling endometrial cavity with cystic components
Pathology
Benign epithelial-lined glands surrounded by hypercellular stroma
Genetics
Variable; no single pathognomonic translocation
Treatment
Total Hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). Adjuvant therapy (chemo/radiation) usually reserved for advanced stage
Prognosis
- Excellent for low-grade tumors confined to the endometrium (5-year survival >90%)
- Prognosis drops with sarcomatous overgrowth or deep myometrial invasion
Workup - Blood Tests
- FBC, U&E, LFTs - preoperative baseline
- Ca-125 - elevated in ovarian cases or advanced disease
Workup - Local Imaging
MRI with contrast of primary site
Workup - Biopsy
Endometrial biopsy
Workup - Staging
CT chest/abdomen/pelvis
Workup - Other
Evaluation for endometriosis
Follow-up Summary
- 1
Speculum and bimanual pelvic examination and CXR or CT chest every 3–4 months for the first 2–3 years, then every 6 months to 5 years
- 2
Annual CT Abdomen/Pelvis if high-grade features present
Medical disclaimer
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