An Infrequent Adenosarcoma Mimicking other Uterine Rhabdoid Tumours
Uterine sarcomas are relatively rare and account for only 1-3% of all malignancies in the Female Genital Tract (FGT). Adenosarcomas of the uterus are uncommon accounting for only 5% of uterine sarcomas. They are considered less recurrent and less metastatic. However, those with sarcomatous overgro...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14585/46963_190121_46963_CE(Ra1)_F[SK]_PF1(SK1_KM)_PFA(SHU_Pr)_PN(SHU).pdf |
| Summary: | Uterine sarcomas are relatively rare and account for only 1-3% of all malignancies in the Female Genital Tract (FGT). Adenosarcomas of
the uterus are uncommon accounting for only 5% of uterine sarcomas. They are considered less recurrent and less metastatic. However,
those with sarcomatous overgrowth and heterologous differentiation are very rare, considered aggressive and need to be differentiated
histologically from other sarcomas that mimic the same clinically and histologically. In the index case, a 50-year-old female presented
with symptoms of pain in the abdomen and bleeding per vagina. Magnetic Resonance Imaging (MRI) showed a large polypoid solid
mass in the endometrium, suggestive of a sarcoma. Positron Emission Tomography (PET) scan showed an Fluorodeoxyglucose (FDG)
avid lesion in the endometrial cavity (SUV max-13.33). Total abdominal hysterectomy and salpingooophorectomy was performed.
Histology showed a biphasic tumour (benign glands and malignant mesenchymal component) with rhabdomyoblastic differentiation
and sarcomatous overgrowth. Presence of rhabdoid cells raises the possibility of other sarcomas with these features making the
diagnosis challenging. Immunohistochemistry (IHC) confirmed it to be a high grade adenosarcoma with sarcomatous overgrowth.
Desmin positivity was noted in the rhabdoid cells. Majority cases of adenosarcoma are low grade, the index case was however
high grade with presence of heterologous elements and sarcomatous overgrowth. Neither radiology nor clinical features can reliably
differentiate adenosarcomas from other uterine sarcomas. A definitive diagnosis can be made by understanding the overlapping
morphological features and correlate it with IHC to reliably differentiate it with other similar looking uterine sarcomas. |
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| ISSN: | 2249-782X 0973-709X |