Daskalaki A, Xenaki S, Athanasakis E, Chrysos E, Chalkiadakis G
Department of General Surgery, University Hospital of Heraklion, 71500 Crete, Greece.
Case Rep Surg. 2015;2015:403431. doi: 10.1155/2015/403431. Epub 2015 Dec 30.
Background. A malignant mixed Müllerian tumor (MMMT) is a malignant neoplasm found in the uterus, the ovaries, the fallopian tubes, and other parts of the body that contains both carcinomatous (epithelial tissue) and sarcomatous (connective tissue) components. Outcome of MMMTs is determined primarily by depth of invasion and stage. The metastatic background of these lesions is controversial and unknown. Case Report. A 75-year-old woman was admitted to the hospital with anorexia, weakness, and persistent coughing. The imaging exams revealed a solid, promiscuous lesion of 16 × 14 cm in dimensions located into the small pelvis, surrounding the uterus and the ovaries. The patient underwent exploratory laparotomy. The mass was removed and the histological examination of the specimen revealed an advanced mesodermal adenocarcinoma of the ovary (MMMT). Nine days after the operation the patient presented with metastatic lesions in the mouth as well as the lungs. Within a month after the discharge from the hospital metastatic lesions of the MMMT were also depicted in the CT brain scan. Conclusion. Despite the fact that sarcomas have a long-term metastatic potential, to our knowledge this is the first case of Müllerian adenosarcoma presenting with such extraperitoneal metastases.
背景。恶性苗勒管混合瘤（MMMT）是一种在子宫、卵巢、输卵管及身体其他部位发现的恶性肿瘤，其包含癌性（上皮组织）和肉瘤性（结缔组织）成分。MMMT的预后主要由浸润深度和分期决定。这些病变的转移背景存在争议且尚不明确。病例报告。一名75岁女性因厌食、虚弱和持续咳嗽入院。影像学检查显示一个大小为16×14厘米的实性、杂乱的病变位于小骨盆，包绕子宫和卵巢。患者接受了剖腹探查术。肿物被切除，标本的组织学检查显示为卵巢高级别中胚层腺癌（MMMT）。术后九天患者出现口腔及肺部转移灶。出院后一个月内，脑部CT扫描也显示出MMMT的转移灶。结论。尽管肉瘤具有长期转移潜能，但据我们所知，这是首例伴有此类腹膜外转移的苗勒管腺肉瘤病例。
