Kumar Sandeep, Raza Muhammad, Tariq Muhammad Usman
Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2018 Aug;68(8):1263-1266.
Mullerian adenosarcoma (MA) of ovary with sarcomatous (rhabdomyoblastic) overgrowth is an extremely rare malignant type of female genital tract neoplasm. These tumours are highly aggressive and presence of heterologous elements is associated with worse prognosis. A 44 year old female presented with lower abdominal pain and distension. She had history of removal of tumour from pouch of Douglas in 2006 for which she did not receive any additional treatment nor did she keep continuous follow up. Current preoperative radiological examination revealed bilateral ovarian masses. She underwent abdominal hysterectomy with bilateral oophorectomy. Microscopic examination revealed biphasic tumours exhibiting sarcomatous overgrowth with rhabdomyoblastic differentiation. Review of the previous biopsy revealed low grade Mullerian adenosarcoma without sarcomatous overgrowth. Hence the current tumour was considered recurrent. This report highlights the aggressive nature of MA even with low grade morphological features and emphasizes the importance of continuous follow up and additional treatment.
伴有肉瘤样（横纹肌母细胞样）过度生长的卵巢苗勒管腺肉瘤是女性生殖道肿瘤中一种极其罕见的恶性类型。这些肿瘤具有高度侵袭性，异源性成分的存在与预后较差相关。一名44岁女性因下腹部疼痛和腹胀就诊。她在2006年有过从Douglas陷凹切除肿瘤的病史，此后未接受任何进一步治疗，也未持续随访。目前的术前影像学检查显示双侧卵巢肿块。她接受了腹式子宫切除术及双侧卵巢切除术。显微镜检查显示为双相性肿瘤，伴有横纹肌母细胞分化的肉瘤样过度生长。回顾先前的活检显示为低级别苗勒管腺肉瘤，无肉瘤样过度生长。因此，当前肿瘤被认为是复发性的。本报告强调了即使具有低级别形态学特征的苗勒管腺肉瘤的侵袭性本质，并强调了持续随访和进一步治疗的重要性。
