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Yi-An Tu, Yu-Li Chen, Ming-Chieh Lin, Chi-An Chen, Wen-Fang Cheng
OBJECTIVE: To report a case and review published cases of large cell neuroendocrine carcinoma (LCNEC) of the endometrium. CASE REPORT: A 51-year-old female presented with postmenopausal bleeding and a palpable pelvic mass. An endometrial biopsy showed a malignant mixed Mullerian tumor (MMMT). Suboptimal debulking surgery was performed. The final pathology revealed stage IVB endometrial LCNEC. Post-operative adjuvant chemotherapy with cisplatin and etoposide was administered...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
V G Vellone, B Spina, F Grillo, P Calamaro, F Sarocchi, P Sala, S Ferrero, E Fulcheri
Chemo-radiation represents an effective therapy for carcinoma of the uterine cervix. The endometrium may however receive a consistent dose of mutagenic radiations and patients may have an increased risk of secondary malignancies. Endometrial mixed malignant mullerian tumor (MMMT) is a rare, highly aggressive disease, and neuroendocrine features are even rarer. A 68 years old woman underwent radio-chemotherapy for a squamous cell carcinoma of the cervix. Follow up was uneventful until, eight years after radio-chemotherapy, imaging exams detected a diffuse enlargement of the uterine body...
December 2017: Pathologica
Hong-Wei Tian, Wei-Bing Yang, Meng-Jie Yang, Jing-Yuan Liu, Jian-Chu Zhang, Xiao-Nan Tao, Qiong Zhou
The lungs are one of the most common organs to which cancer metastasizes, but are a location not common for uterine sarcoma. A malignant mixed Müllerian tumor (MMMT) of the uterus is an extremely rare and aggressive sarcoma, characterized by a mixture of epithelial and mesenchymal components. There are few reports regarding the pulmonary metastasis from MMMTs. The present study presents the case of a 58-year-old woman with hemoptysis and post-menopausal vaginal bleeding. The woman was initially diagnosed with invasive aspergillosis based on a chest computed tomography (CT) scan showing multiple pulmonary nodular opacities surrounded by a ground-glass attenuation halo (halo-sign)...
December 2017: Oncology Letters
Mauro Del Papa, Gabriele D'Amata, Fulvio Manzi, Luca Musmeci, Marco Crovaro, Carlo Buonocore, Gaetano Florio, Andrea Giannetti
INTRODUCTION: Primary malignant mixed mesodermal tumor (MMMt, also called malignant mixed Mullerian tumor and designated in the WHO classification of female genital tract neoplasms as carcinosarcoma) is an infrequent tumor that develops usually in the uterus and more rarely in the ovary. Extragenital tumor, including primary peritoneal MMMt, is an extremely rare and aggressive neoplasm with only few case reported in the literature. PRESENTATION OF CASE: We report a case of a 70-year's old female who presented with nausea and abdominal discomfort for 6 months...
2017: International Journal of Surgery Case Reports
Octavio Chavez Herbas, Beatriz E Garcia-Prieto, Ilmana Fulger
We present a case of a 61-year-old postmenopausal woman with a known diagnosis of malignant mixed müllerian tumor (MMMT) originally treated with systemic chemotherapy and total abdominal hysterectomy plus bilateral salpingo-oophorectomy, who developed a left cervical mass noted on a follow-up visit. Imaging and nuclear testing were both performed confirming the presence of a cervical mass arising from the thyroid. Our patient underwent surgical resection of the mass, and biopsy of the specimen was consistent with metastatic uterine carcinosarcoma mixed müllerian tumor...
November 15, 2017: Tumori
Xiaowei Chen, Rebecca Arend, Diane Hamele-Bena, Ana I Tergas, Melanie Hawver, Guo-Xia Tong, Thomas C Wright, Jason D Wright
Carcinosarcomas (malignant mixed Müllerian tumors or MMMT) are rare malignant tumors in the female genital tract composed of both malignant epithelial and malignant mesenchymal components. They comprise <5% of all neoplasms in the gynecologic tract and have an aggressive clinical course. The purpose of this study is to evaluate the immunophenotype and possible histogenesis of carcinosarcomas of the uterus. Sixty-two cases of uterine carcinosarcomas diagnosed between 1995 and 2011 were retrieved from the gynecologic pathology files at Columbia University Medical Center...
September 2017: International Journal of Gynecological Pathology
Silvana Grasso, Vera Loizzi, Valentina Minicucci, Leonardo Resta, Anna Lina Camporeale, Ettore Cicinelli, Gennaro Cormio
OBJECTIVES: The aim of our study was to evaluate the clinicopathological features and prognostic factors of uterine carcinosarcoma. PATIENTS AND METHODS: In this retrospective study, the clinical characteristics of 44 patients with uterine MMMT were evaluated. Survival curves were estimated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: Forty-four patients with uterine carcinosarcoma were referred to our unit between 1995 and 2015...
2017: Oncology
S F Lax
The 2014 World Health Organization (WHO) classification of uterine tumors revealed simplification of the classification by fusion of several entities and the introduction of novel entities. Among the multitude of alterations, the following are named: a simplified classification for precursor lesions of endometrial carcinoma now distinguishes between hyperplasia without atypia and atypical hyperplasia, the latter also known as endometrioid intraepithelial neoplasia (EIN). For endometrial carcinoma a differentiation is made between type 1 (endometrioid carcinoma with variants and mucinous carcinoma) and type 2 (serous and clear cell carcinoma)...
November 2016: Der Pathologe
Geetha Visvalingam, Wai Kheong Ryan Lee, Chin Fong Wong, Yong Kuei Lim
Primary malignant mixed Müllerian tumour (MMMT) of the vagina is a rare entity. We report a case of a 62-year-old woman who presented with a fixed and hard anterior vaginal wall mass with contact bleeding. She proceeded to have an anterior infralevator pelvic exenteration with urethrectomy and anterior vaginectomy, creation of an ileal conduit and bilateral lymph node dissection. Histopathological examination and immunohistochemistry confirmed the diagnosis of primary MMMT of the vagina. The patient was stage IVA at diagnosis...
April 25, 2016: BMJ Case Reports
Lei Zhang, David Shimizu, Jeffrey L Killeen, Stacey A Honda, Di Lu, Alexander Stanoyevitch, Fritz Lin, Beverly Wang, Edwin S Monuki, Michele Carbone
The stage I uterine malignant mixed mullerian tumor (MMMT) shows different potential for progression. We reason that MMMTs with high-grade carcinomatous component and positivity for HB-EGF are prone to recurrence/metastasis in the early stage. A retrospective clinical and histopathologic review with immunohistochemical staining for HB-EGF, EGFR, and integrin-α5 was performed for 62 surgically staged MMMT cases. Recurrence/metastasis (RM) is 6/18 (33%) in stage I disease. Of all the clinicopathologic variables and biomarkers analyzed for stage I MMMT, serous carcinomatous component (83% [5/6] versus 17% [1/12], P = ...
July 2016: Human Pathology
A Daskalaki, S Xenaki, E Athanasakis, E Chrysos, G Chalkiadakis
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...
2015: Case Reports in Surgery
Robert A Soslow
Malignant mixed müllerian tumor (MMMT) and müllerian/mesodermal adenosarcoma are 2 of the most common mixed müllerian tumors of the female genital tract. MMMT is a biphasic neoplasm, composed of morphologically malignant epithelial and stromal components. MMMT should be distinguished from endometrioid adenocarcinoma with spindle cell elements, "dedifferentiated" endometrioid carcinoma, and combined adenocarcinoma and neuroendocrine carcinoma. Adenosarcoma is also biphasic; it is composed of morphologically benign or low-grade appearing epithelial components and malignant stromal components...
December 2009: Surgical Pathology Clinics
Esther Oliva, Robert A Soslow
High-grade endometrial carcinomas are a heterogeneous group of clinically aggressive tumors. They include FIGO grade 3 endometrioid carcinoma, serous carcinoma, clear cell carcinoma, undifferentiated carcinoma, and malignant mixed Müllerian tumor (MMMT). Epidemiologic, genetic, biologic prognostic and morphologic differences between these entities are striking in prototypic cases, yet substantial overlap exists and diagnostic criteria and therapeutic approaches that account for the group's diversity are currently insufficient...
March 2011: Surgical Pathology Clinics
J M L Williamson, M Stevens, D Mahon
A mixed Müllerian mesodermal tumour (MMMT) is a rare aggressive carcinosarcoma. Metastatic progression is uncommon, and occurs via haematological, lymphatic and intraperitoneal spread. Although the latter is seen most frequently, the small intestine seems to be relatively preserved from disease progression with only one reported case of synchronous involvement. We report a case of metachronous MMMT involvement of the small bowel presenting with subacute obstruction that was successfully resected at operation...
February 2016: Annals of the Royal College of Surgeons of England
Stefanie Burghaus, Sonja Halmen, Paul Gass, Grit Mehlhorn, Michael G Schrauder, Michael P Lux, Stefan P Renner, Matthias W Beckmann, Alexander Hein, Falk C Thiel
PURPOSE: There is low evidence regarding the optimal treatment in patients with uterine sarcomas and malignant mixed Mullerian tumors (MMMTs). This study provides an overview of experience at our center with patients diagnosed with uterine sarcoma and MMMT, in relation to the clinical management and outcome. METHODS: The medical records for 143 patients with low-grade endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and high-grade (undifferentiated) endometrial sarcoma (UES) and MMMT were reviewed...
August 2016: Archives of Gynecology and Obstetrics
Eusebio S Pires, Ryan S D'Souza, Marisa A Needham, Austin K Herr, Amir A Jazaeri, Hui Li, Mark H Stoler, Kiley L Anderson-Knapp, Theodore Thomas, Arabinda Mandal, Alain Gougeon, Charles J Flickinger, David E Bruns, Brian A Pollok, John C Herr
The metalloproteinase SAS1B [ovastacin, ASTL, astacin-like] was immunolocalized on the oolemma of ovulated human oocytes and in normal ovaries within the pool of growing oocytes where SAS1B protein was restricted to follicular stages spanning the primary-secondary follicle transition through ovulation. Gene-specific PCR and immunohistochemical studies revealed ASTL messages and SAS1B protein in both endometrioid [74%] and malignant mixed Mullerian tumors (MMMT) [87%] of the uterus. A MMMT-derived cell line, SNU539, expressed cell surface SAS1B that, after binding polyclonal antibodies, internalized into EEA1/LAMP1-positive early and late endosomes...
October 6, 2015: Oncotarget
Krisztina Z Hanley, Gabriela Oprea-Ilies, Claudia Ormenisan, Shabnam Seydafkan, Marina B Mosunjac
OBJECTIVE: A malignant mixed müllerian tumor (MMMT) is a high-grade neoplasm commonly arising from the uterus. Patients present with bleeding and a mass protruding from the cervix. This study was designed to correlate Papanicolaou (Pap) smear findings with histological findings in women diagnosed with MMMT. STUDY DESIGN: Women diagnosed with MMMT were identified. Preoperative Pap tests were correlated with histological findings. Statistical analysis was performed to assess associations between abnormal Pap tests and histological findings...
2015: Acta Cytologica
Yun Zhou, He Huang, Lin-Jing Yuan, Ying Xiong, Xin Huang, Jia-Xin Lin, Min Zheng
BACKGROUND: Uterine sarcoma is an aggressive malignancy with a poor prognosis. This study aimed to determine the expression of CD146, P53, and Ki-67 in uterine sarcoma and to evaluate their prognostic significance. METHODS: We retrospectively analyzed the prognosis and clinicopathologic features of 68 patients with uterine sarcoma. Immunohistochemical analyses of CD146, P53, and Ki-67 were performed in tissue samples collected from these patients and their relationship with prognosis was investigated...
August 21, 2015: European Journal of Medical Research
Helen K Könnecke, Elisabeth J Rushing, Marian Christoph Neidert, Regina Reimann, Luca Regli, Oliver Bozinov, Jan-Karl Burkhardt
Involvement of the central nervous system (CNS) is rarely described in malignant mixed Müllerian tumors (MMMTs). Only four intracranial and two spinal cases have been published to date. Here we report two more cases with heterogeneous clinical, radiologic and pathologic features and summarize the available contemporary literature. One patient presented with aphasia due to an intra-axial contrast-enhanced left temporal lesion with marked perifocal edema. After surgical resection, histology showed collections of small uniform tumor cells embedded in a myxoid matrix and compartmentalized by connective tissue septations, consistent with an MMMT...
September 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Mayank Gupta, Kala Gnanasekaran Kiruthiga
Tamoxifen is used in the treatment of hormone responsive breast cancer because of its antiestrogenic effect. However, it also has an estrogenic effect on the uterus, thereby increasing the risk of endometrial hyperplasia, endometrial polyp and endometrial neoplasms such as endometrial adenocarcinoma and malignant mixed Mullerian tumour (MMMT). This case describes the possible pathogenesis and risk of developing MMMT due to long-term tamoxifen intake in hormone responsive breast cancer.
June 29, 2015: BMJ Case Reports
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