Charfi Slim, Kallel Rim, Mnif Hela, Ellouze Sameh, Dhouib Mohamed, Guermazi Mohamed, Khabir Abdelmajid, Sellami-Boudawara Tahya
Laboratoire D'anatomie et de Cytologie Pathologiques, Department of Pathology, CHU Habib Bourguiba, 3029 Sfax, Tunisia.
Case Rep Obstet Gynecol. 2012;2012:358302. doi: 10.1155/2012/358302. Epub 2012 Aug 16.
Mullerian adenosarcoma of the cervix is a rare tumor composed of benign epithelial and malignant stromal components. Sarcomatous overgrowth and heterologous elements in cervical adenosarcoma are extremely infrequent. We report the case of a 26-year-old woman admitted at the gynaecology department for a painless mass protruding from her vagina. The initial pathological exam concluded to endocervical polyp. Six months later, the patient was readmitted with a recurrence of the polyp. The pathological exam demonstrated interlacing fascicles of elongated spindle cells with few mitotic activity and no glandular formation. After reviewing of the initial polyp the diagnosis of mullerian adenosarcoma was suggested. A second recurrence of the polyp was noted one month later. Histopathological exam of the recurrent polyp confirmed the diagnosis of adenosarcoma with sarcomatous overgrowth and heterologous elements. The patient was lost for follow-up. Cervical adenosarcoma with sarcomatous overgrowth and heterologous element is a rare tumor that occurs in younger age in contrast to endometrium/corpus uterin mullerian adenosarcoma. In young women with recurrent cervical polyp, mullerian adenosarcoma must be considered and should be excluded by careful histopathological exam. Sarcomatous overgrowth and myometrial invasion are the most important prognostic factors. Treatment strategy is still unclear.
宫颈苗勒管腺肉瘤是一种罕见的肿瘤,由良性上皮成分和恶性间质成分组成。宫颈腺肉瘤中的肉瘤过度生长和异源性成分极为罕见。我们报告一例26岁女性,因阴道无痛性肿物入住妇科。最初的病理检查诊断为宫颈息肉。6个月后,患者因息肉复发再次入院。病理检查显示为细长梭形细胞的交织束状结构,有少量有丝分裂活性,无腺体形成。在复查最初的息肉后,提示为苗勒管腺肉瘤。1个月后息肉再次复发。复发性息肉的组织病理学检查确诊为伴有肉瘤过度生长和异源性成分的腺肉瘤。患者失访。与子宫内膜/子宫体苗勒管腺肉瘤相比,伴有肉瘤过度生长和异源性成分的宫颈腺肉瘤是一种罕见肿瘤,发病年龄较轻。对于复发性宫颈息肉的年轻女性,必须考虑苗勒管腺肉瘤,并应通过仔细的组织病理学检查予以排除。肉瘤过度生长和肌层浸润是最重要的预后因素。治疗策略仍不明确。