2018 Volume 70 Issue 2 Pages 75-81
Adenosarcoma is a rare tumor characterized by a stromal component usually of low-grade malignancy and by a benign glandular epithelial component. In most cases, it occurs in the uterus of women with a mean age of 58 years old. Here we present an unusual case of adenosarcoma arising in an extragenital site, the pelvic peritoneum (serosa of uterus), in association with endometriosis. A 35-year-old nulliparous woman, presented to a local clinic with vaginal bleeding for three months. She was referred with a suspicion of corpus cancer as she was found to have a tumor from the fundus and CA 19-9 and CA 125 levels were elevated. She had a medical history of endometriosis and was on medication for several months but discontinued due to economic reasons. On magnetic resonance imaging, she was found to have a highly enhanced mass measuring 8 cm, arising from the anterior surface of the uterus. Following examination, we suspected a malignant tumor involving peritoneal carcinoma. The patient underwent a complete surgical staging including total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymphadenectomy. There was no gross residual disease at the completion of surgery. After surgery, she had no complications, and was discharged on day 14. Histology showed no metastatic lesions in the bilateral adnexa or lymph nodes, and no disseminated lesion in the omentum. Although pathological findings demonstrated extragenital adenosarcoma, no adverse prognostic features (i.e. sarcomatous overgrowth and no lymphovascular invasion etc.) were identified, so no adjuvant therapy was used in this case. As of now, two months post-surgery, the patient remains disease free. [Adv Obstet Gynecol, 70 (2) : 75-81, 2018 (H30.5)]
