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Aim Mullerian adenosarcomas are rare tumors with a low malignant potential whose stromal component is often a low-grade endometrial stromal sarcoma. Rarely, they can harbor foci of uterine tumors resembling ovarian sex cord tumors (UTROSCT). We propose that the presence of UTROSCT components is associated with an improved survival. Materials and results Six patients, age range 39-71 years, two on tamoxifen treatment, presented with vaginal bleeding. Four had uterine intracavitary polypoid tumors; one originated in the isthmus and involved the endocervical canal. Only one was located in the ovary. Tumors ranging in size from 2.5 to 19 cm were all in stage 1. Morphologically, all had prominent UTROSCT-like components that comprised at least 25% of tumor volume (criteria for stromal overgrowth); only one was associated with superficial myometrial involvement (1–2 mm). Immunohistochemically, the UTROSCT component was invariably positive for CAM 5.2, CD 56, Inhibin, Calretinin, AR, PR and α-actin. All patients were alive without disease at 8–84 months. Conclusions Compared to adenosarcomas overgrown by high-grade sarcoma, UTROSCT overgrowth is low-grade and is not associated with recurrence or metastasis in this small series. Therefore, extensive UTROSCT-like growth in the context of adenosar-coma should not be equated with stromal overgrowth in these tumors. |
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