RESUMO
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.
Assuntos
Tumor Mulleriano Misto/patologia , Neoplasias Uterinas/patologia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/secundário , Neoplasias da Mama/secundário , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Terapia Combinada , Ciclofosfamida/administração & dosagem , Evolução Fatal , Feminino , Neoplasias Femorais/secundário , Humanos , Histerectomia , Ifosfamida/administração & dosagem , Ílio , Pessoa de Meia-Idade , Tumor Mulleriano Misto/tratamento farmacológico , Tumor Mulleriano Misto/radioterapia , Tumor Mulleriano Misto/secundário , Tumor Mulleriano Misto/cirurgia , Segunda Neoplasia Primária , Ovariectomia , Paclitaxel/administração & dosagem , Cuidados Paliativos , Neoplasias Pélvicas/secundário , Neoplasias Pélvicas/cirurgia , Prognóstico , Radioterapia Adjuvante , Sarcoma de Ewing , Neoplasias da Coluna Vertebral/secundário , Neoplasias Uterinas/tratamento farmacológico , Neoplasias Uterinas/radioterapia , Neoplasias Uterinas/cirurgiaRESUMO
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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
