ABSTRACT
Malignant mixed Mullerian tumours (MMMTs) are rare neoplasms, highly aggressive and with an extremely poor prognosis, usually arising in elderly postmenopausal women and presenting at an advanced stage. MMMTs derive from the mullerian mesodermus that differentiates in epithelial and stromal elements, both malignant elements. The clinic pathological features of 3 uterine MMMTs are reported here. The patients ranged in age from 25 to 69 years. The initial manifestations were mainly bloody discharge, abdominal pain and increase of the volume of the uterus. Treatment in 2 patients was hysterectomy with double ooforectomy, and resection of the pelvic mass was the treatment in the third case. Adjuvant radio chemotherapy was administrated in 2 of the 3 cases. Follow-up revealed recurrent pelvic tumour in 1 patient at 59 months, and breast metastases at 20 months in the second one. Because of the high incidence of recurrence and poor prognosis of these tumours, they should be studied and managed by a multidisciplinary team composed by surgeons, oncologists, radiotherapists and pathologists.
Subject(s)
Mixed Tumor, Mullerian/pathology , Uterine Neoplasms/pathology , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/secondary , Breast Neoplasms/secondary , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Fatal Outcome , Female , Femoral Neoplasms/secondary , Humans , Hysterectomy , Ifosfamide/administration & dosage , Ilium , Middle Aged , Mixed Tumor, Mullerian/drug therapy , Mixed Tumor, Mullerian/radiotherapy , Mixed Tumor, Mullerian/secondary , Mixed Tumor, Mullerian/surgery , Neoplasms, Second Primary , Ovariectomy , Paclitaxel/administration & dosage , Palliative Care , Pelvic Neoplasms/secondary , Pelvic Neoplasms/surgery , Prognosis , Radiotherapy, Adjuvant , Sarcoma, Ewing , Spinal Neoplasms/secondary , Uterine Neoplasms/drug therapy , Uterine Neoplasms/radiotherapy , Uterine Neoplasms/surgeryABSTRACT
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Malignant mixed mullerian tumours (MMMTs) arerare neoplasms, highly aggressive and with an extremelypoor prognosis, usually arising in elderlypostmenopausal women and presenting at an advancedstage. MMMTs derive from the mullerianmesodermus that differentiates in epithelial andstromal elements, both malignant elements.The clinic pathological features of 3 uterine MMMTsare reported here. The patients ranged in age from25 to 69 years. The initial manifestations weremainly bloody discharge, abdominal pain and increaseof the volume of the uterus. Treatment in 2patients was hysterectomy with double ooforectomy,and resection of the pelvic mass was the treatmentin the third case. Adjuvant radio chemotherapywas administrated in 2 of the 3 cases. Follow-uprevealed recurrent pelvic tumour in 1 patient at 59months, and breast metastases at 20 months in thesecond one.Because of the high incidence of recurrence andpoor prognosis of these tumours, they should bestudied and managed by a multidisciplinary teamcomposed by surgeons, oncologists, radiotherapistsand pathologists
Subject(s)
Female , Adult , Aged , Middle Aged , Humans , Mixed Tumor, Mullerian/pathology , Uterine Neoplasms/pathology , Mixed Tumor, Mullerian/surgery , Carcinosarcoma/pathology , Metaplasia/pathologyABSTRACT
Objetivo: Evaluar la incidencia de cáncer uterino en mujeres con cáncer de mama tratadas con tamoxifeno. Material y método: Evaluamos a 463 mujeres que se trataron con 20 mg/día de tamoxifeno por una cáncer de mama dependiente de hormonas, con un seguimiento de 6 años. Resultados: Detectamos 7 cánceres uterino s (1,55% de la población en estudio y 2,52/1.000 mujeres/año): 5 adenocarcinomas de endometrio, 1 tumor mulleriano mixto heterólogo y 1 sarcoma de la estroma endometrial. Sólo el crecimiento rápido de 10 que creíamos un mioma uterino detectado por ecografía nos permitió el diagnóstico del sarcoma de la estroma endometrial; los otros 6 tumores se detectaron por la aparición de hemorragia vaginal, a pesar de realizarse controles anuales al grupo de estudio. Conclusiones: Encontramos una mayor incidencia de cáncer uterino en mujeres con cáncer de mama tratadas con tamoxifeno, pero no representa el doble que en la población general. Hubo adenocarcinomas de endometrio principalmente, aunque encontramos también 2 sarcomas (un sarcoma de la estroma endometrial y 1 tumor mulleriano mixto heterólogo) (AU)
Objective: To evaluate the incidence of uterine cancer in women with breast cancer who had been treated with Tamoxifen. Material and methods: We evaluate 463 women who were treated with 20mg of Tamoxifen daily for a hormone dependent breast cancer, and followed up for 6 years. Results: We detected 7 uterine cancers (1.55% of the study population and 2.52 /1.000 women ayear). Of these, 5 were endometrial carcinomas, a malignant heterologous mixed mesodermal tumour and one endometrial stromal sarcoma. Only the rapid growth of what we believed to be a uterine myoma, detected by ultrasound, allowed us to diagnose the endometrial stromal sarcoma. The other 6 tumours were detected by the appearance of vaginal bleeding, in spite of the annual controls carried out on the study group. Conclusions: We find a higher incidence of uterine cancer in women with Tamoxifen treated breast cancer, but it is not the double of the general population. We found mainly endometrial carcinomas, although there were also 2 sarcomas (an endometrial stromal sarcoma and a malignant heterologous mixed mesodermal tumour) (AU)
