[Mullerian adenosarcoma of the uterus]

The paper describes a case of mullerian adenosarcoma of the uterus. The patient, a 58-year old postmenopausal woman, presented with atypical vaginal bleeding and enlarged uterus. A total hysterectomy was performed. The intrauterine mass measured 10 cm in largest diameter and had bossolated surface and 2 pedicles of 3 and 4 mm each. The cut section was white-pink in color and contained small cysts in about two third of its volume. Myometrium was not infiltrated by tumor. On microscopic examination, the tumor consisted of round glands surrounded by myofibroblastic stroma which was condensed around the glands. Glandular epithelium was pseudostratified and showed ciliated, tubal and mucinous differentiation. Periglandular stroma cells were atypical and pleiomorphic and mitotically active. The part of the tumor which lacked glands had prominent smooth muscle differentiation. Immunohistochemically stromal cells stained positively for vimentin and smooth muscle specific alpha-actin; desmin without predigestion was extensively negative.