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• W4240620905 abstract "Mullerian adenosarcoma of the cervix is a biphasic gynecologic neoplasm, consisting of a benign epithelial component and a malignant stromal component. Patients often present with symptoms including abnormal bleeding, discharge, or the presence of a vaginal mass. While Mullerian adenosarcomas of the cervix affect women of all ages, approximately one third of cases are reported in children aged 10 to 15. These lesions are easily mistaken as benign cervical polyps, but have a high potential for local recurrence that warrants careful histologic diagnosis. A 14-year-old girl presented with a bulging vaginal mass to her Obstetrician-Gynecologist. Her only past medical history was a urinary tract infection two weeks prior. On exam, a friable, polypoid lesion that occupied the entire vagina and protruded beyond the introitus was noted. An examination under anesthesia revealed the mass originated from the anterior cervical lip and measured approximately 4 centimeters in maximum dimension. The mass was resected, and the remainder of the exam was within normal limits. Microscopic examination noted neoplastic stroma with overlying squamous and columnar epithelium consistent with Mullerian adenosarcoma. The lesion was negative for necrosis, sarcomatous overgrowth, and lymphovascular invasion. The tissue stained positive for CD 10, SMA, and Ki-67. There was multifocal desmin positivity, which raised concern for rhabdomyosarcoma; however, stains were negative for myogenin and Myf4. The ultimate diagnosis was low grade Mullerian adenosarcoma of the cervix, FIGO stage 1B1. The surgical margins were positive. The patient subsequently underwent a CT scan of her chest, abdomen, and pelvis that demonstrated no sites of metastasis. She then underwent a cervical LEEP. Pathology showed microscopic residual sarcoma 0.5 millimeters from the biopsy margin. After being counseled regarding the close surgical margin, the patient and her family elected to proceed with cold knife conization of her cervix, with negative surgical margins and no residual malignancy. Endocervical curettage was negative. Mullerian adenosarcoma of the cervix is a rare entity whose optimal management is unknown. The absence of sarcomatous overgrowth and heterologous elements is associated with a favorable prognosis. Many of the patients diagnosed with Mullerian adenosarcoma of the cervix are young. For patients with low grade lesions who desire to preserve fertility, local excision may be a reasonable option in the setting of good follow-up, as most reported recurrences are local." @default.
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• W4240620905 date "2017-04-01" @default.
• W4240620905 modified "2023-09-25" @default.
• W4240620905 title "Management of Low Grade Cervical Mullerian Adenosarcoma in A 14 Year-Old Girl" @default.
• W4240620905 doi "https://doi.org/10.1016/j.jpag.2017.03.092" @default.
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