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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)...
October 13, 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...
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.
2015: BMJ Case Reports
K K Deodhar, B Rekhi, S Menon, B Ganesh
BACKGROUND: The aim was to assess compliance to reporting minimum data sets in carcinoma endometrium reports, in a team of 13 pathologists, and also to analyze parameters such as. tumor size, type, grade, depth of myometrial invasion, lymph node yield, pTNM stage etc. MATERIALS AND METHODS: Reports of 114 cases of carcinoma endometrium, that were operated in-house during the years 2008 to 2010 were analyzed from the files of the Pathology department of our hospital...
April 2015: Journal of Postgraduate Medicine
Claire Sénéchal, Edouard Cottereau, Antoine de Pauw, Camille Elan, Isabelle Dagousset, Virginie Fourchotte, Marion Gauthier-Villars, Marick Lae, Dominique Stoppa-Lyonnet, Bruno Buecher
In France, endometrial cancer is at the first rank of gynecological cancers for cancer incidence, before ovarian and cervical cancers. In fact, the number of incident cases has been estimated to 7275 for the year 2012; the number of death due to endometrial cancer to 2025. This cancer is hormone-dependent and endogenous (reproductive factors) or exogenous (oral combined contraceptives, hormone replacement therapy) causes of exposition to estrogens are the major environmental risk factors for both types of endometrial cancers: type I or well-differentiated endometrioid adenocarcinomas; and type II including all other histological types: papillary serous adenocarcinomas, clear cell adenocarcinomas and carcinosarcomas, also known as malignant mixed Mullerian tumor, MMMT...
March 2015: Bulletin du Cancer
Fatemeh Homaei Shandiz, Sima Kadkhodayan, Malihe Hsanzade Mofrad, Zohre Yousefi Roodsari, Noorieh Sharifi Sistani, Majid Nabizadeh Marvast, Mahbobe Sadeghei
INTRODUCTION: Malignant Mixed Mullerian Tumor (MMMT) is a very rare tumor, accounting for less than 1% of all ovarian cancers. CASE PRESENTATION: We present a 64-year-old woman with stage III MMMT of ovary that was treated with platinum-based chemotherapy after optimal cytoreductive surgery. After 25 months of being disease free, she had a pelvic recurrence and a good response to chemoradiotherapy. CONCLUSIONS: Optimal cytoreductive surgery and chemotherapy may be the best treatment in MMMT but more discussion and experiences are needed regarding the effectiveness of radiotherapy...
September 2014: Iranian Red Crescent Medical Journal
E Y Ki, J S Park, J B Mun, S Y Hur
Malignant mixed mesodermal tumors (MMMTs) are highly aggressive and usually diagnosed at advanced stages. MMMT originates from either the ovary or the uterus. Because this disease is relatively rare, an optimal treatment modality has not yet been established. The authors report four cases of ovarian MMMT (one heterologous MMMT and three homologous MMMTs) during 1990-2011. The patients underwent operation immediately after histopathologically confirmation and were treated with platinum-based combination chemotherapy...
2014: European Journal of Gynaecological Oncology
E Y Ki, J S Park, J B Mun, S Y Hur
Malignant mixed mesodermal tumors (MMMTs) are highly aggressive and usually diagnosed at advanced stages. MMMT originates from either the ovary or the uterus. Because this disease is relatively rare, an optimal treatment modality has not yet been established. The authors report four cases of ovarian MMMT (one heterologous MMMT and three homologous MMMTs) during 1990-2011. The patients underwent operation immediately after histopathologically confirmation and were treated with platinum-based combination chemotherapy...
2014: European Journal of Gynaecological Oncology
Ling Shen, Liangli Hong, Guohong Zhang, Ruiqin Mai
Uterine carcinosarcoma (malignant mixed Müllerian tumor, MMMT) is a rare aggressive malignant tumor, which demonstrates both malignant epithelial (carcinoma) and mesenchymal (sarcoma) components. Synchronous uterine carcinosarcoma and contralateral breast cancer in patient received tamoxifen treatment had not been reported. We present a case of uterine carcinosarcoma co-occurrenced with contralateral breast cancer in a 56-year-old nulliparous, obese breast cancer patient, who had been treated with tamoxifen for 5 years...
2014: International Journal of Clinical and Experimental Pathology
Jean-Baptiste Guy, Jane-Chloé Trone, François Casteillo, Fabien Forest, Cécile Pacaut, Coralie Moncharmont, Sophie Espenel, Alexis Vallard, Julien Langrand Escure, Olivier Collard, Michel Peoc'h, Nicolas Magné
Carcinosarcoma, also known as mixed mesodermal tumor or malignant mixed Mullerian tumor (MMMT) is a pathological entity combining a sarcomatous and a carcinomatous component. Found in thoracic, digestive, genitourinary, liver or skin locations, the most common location is the female genital tract. In gynecological tumors, carcinosarcoma accounts for about 2-5% of endometrial cancers, and 1% of ovarian cancers. To date, there is no consensus on the therapeutic strategy. It relies mostly on maximum cytoreductive surgery...
July 2014: Bulletin du Cancer
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