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- Title
THE MORPHOLOGICAL SPECTRUM OF THE SARCOMATOUS COMPONENT IN UTERINE MÜLLERIAN ADENOSARCOMA WITH SARCOMATOUS OVERGROWTH: A Case Series on the Diagnostic Challenges in Biopsy Specimens.
- Authors
Brett, Mary Anne; Agboola, Julius; Ready, Kirk; Daya, Dean; Sur, Monalisa; Lytwyn, Alice
- Abstract
Objective: Mllerian adenosarcomas (MA) are biphasic tumours with benign epithelial elements and malignant mesenchymal stroma. Characteristic features include cellular stroma, periglandular stromal condensation, and leaf-like architecture. While 2 MF/10 HPF has been suggested for minimum diagnostic criteria, myoinvasive MA with lesser mitotic counts are reported. MA with sarcomatous overgrowth (SO) has been described as sarcomatous areas ˃25% of tumour volume, with sex cord like elements excluded in this definition. Current WHO definition specifies high-grade sarcomatous change and sets no volume minimum. We describe the morphological variations in the sarcomatous areas of MA-SO identified in our practice files. Results: We identified 3 patients with MA-SO. (1) A 32-year-old woman presented with abnormal vaginal bleeding. Endometrial curettings revealed an atypical adenofibromatous tumour with 1 MF/10 HPF. Hysterectomy showed MA with low grade SO and areas with sex cord-like differentiation. (2) A 60-year-old woman with radiation-treated cervical cancer presented with abdominal cramping. Hysterectomy revealed MA with high grade SO extending to the serosa and cervical stroma. (3) A 77-year-old woman presented with post-menopausal bleeding and unintentional weight loss. Endometrial curettings were read as complex atypical hyperplasia and symplastic leiomyomata. Hysterectomy showed MA-high grade SO with an adipocytic heterologous component. A non-contiguous focus of endometrial adenocarcinoma was judged to be a second primary tumour. Conclusion: MA-SO are uncommon malignant tumours that can display a wide variation of morphological features within the sarcomatous areas. Small biopsies can be challenging and pose potential diagnostic pitfalls. Conclusion: MA-SO are uncommon malignant tumours that can display a wide variation of morphological features within the sarcomatous areas. Small biopsies can be challenging and pose potential diagnostic pitfalls.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, Issue 4, p42
- ISSN
1918-915X
- Publication type
Article