Müllerian adenosarcoma: A review of cases and literature

Objective: Müllerian adenosarcoma usually originates in the endometrium and grows as a polypoid mass in post-menopausal women presenting as abnormal vaginal bleeding. This report reviewed Müllerian adenosarcoma cases to clarify the clinical and pathologic characteristics. Materials and Methods: Fifteen cases of Müllerian adenosarcoma in two medical centers covering a 15-year period were reviewed. Their clinical characteristics, pathologic findings, treatment, and outcomes were compared. Results: Of the 15 cases, three originated from the endometrium, six arose from uterine adenomyosis, three from the adnexa, and three from the cervix. There was only one post-menopausal case. One case was of breast cancer with tamoxifen (TMX) therapy. There were four Müllerian adenosarcoma with sarcomatous overgrowth (MASO) cases, three of which died within one year after surgery. Only the focal MASO case survived. Conclusion: The rare variant of MASO is very aggressive and associated with poor prognosis.