Malignant mixed mullerian tumor (MMMT) is an unusual tumor composed of malignant epithelial and nonepithelial components in the same lesion and is subdivided into homologous and heterologous types. Epidemiologically, these tumors are associated with prior pelvic irradiation, functioning ovarian lesions, exogenous estrogen therapy and rarely endometriosis. We experienced a case of uterine MMMT which arose from adenomyosis in a 47-year-old woman who had no specific past medical history. The posterior uterine corpus showed a 3.5x3.0x2.0 cm sized, relatively well defined tumor mass within the background of the adenomyosis.
The tumor was composed of well differentiated endometrial adenocarcinoma and sarcomatous stroma with foci of rhabdomyosarcomatous differentiation confirmed by immunohistochemical and electron microscopic studies.
Through the immunohistochemical study, both the epithelial and nonepithelial components were positive for cytokeratin and it suggested that the sarcomatous area originated from metaplasia of the adenocarcinoma component. From the overall findings, it is regarded as an uterine heterologous MMMT which arose from adenomyosis.
The clinical and pathological features of a case Malignant mixed mullerian tumor of the ovary in 45 year-old female patient with a brief review of the literature are presented.
She had both ovarian tumors. The masses are multilocular cystic tumor with interspersed solid component. The cystic component is filled with serous fluid. Microscopically the tumor is composed of epithelial element & intimately related mesenchymal element. The epithelial element shows the findings of adenocarcinoma of solid, glandular and papillary growth. The mesenchymal element is composed of malignant-looking stroma with cartilage formation.