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Difference between revisions of "Uterine tumours"
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→Adenosarcoma of the uterus
m (→Variants: redo ref.) |
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*Most commonly uterine corpus, occasionally cervix and ovary, rarely in the vagina, fallopian tube, peritoneal surfaces, intestine. | *Most commonly uterine corpus, occasionally cervix and ovary, rarely in the vagina, fallopian tube, peritoneal surfaces, intestine. | ||
*Typically 30-40 years old. | *Typically 30-40 years old. | ||
Clinical - based on a series of 41 individuals:<ref name=pmid9625851>{{Cite journal | last1 = Verschraegen | first1 = CF. | last2 = Vasuratna | first2 = A. | last3 = Edwards | first3 = C. | last4 = Freedman | first4 = R. | last5 = Kudelka | first5 = AP. | last6 = Tornos | first6 = C. | last7 = Kavanagh | first7 = JJ. | title = Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience. | journal = Oncol Rep | volume = 5 | issue = 4 | pages = 939-44 | month = | year = | doi = | PMID = 9625851 }}</ref> | |||
*Most common presentation (as percentage of Müllerian adenosarcoma cases): | |||
**Vaginal bleeding ~70%. | |||
**Pelvic mass ~40%. | |||
**Uterine polyp ~30%. | |||
Treatment: | Treatment: | ||
*TAH-BSO. | *TAH-BSO. | ||
**Tumours are estrogen responsive. | **Tumours are estrogen responsive. | ||
*Chemotherapy (platin-based).<ref name=pmid9625851/> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=Ref_PBoD1089>{{Ref PBoD|1089}}</ref><ref name=pmid20179434/> | Features:<ref name=Ref_PBoD1089>{{Ref PBoD|1089}}</ref><ref name=pmid20179434/> | ||
*"Malignant stroma" - '''key feature'''. | *"Malignant stroma" - '''key feature'''. | ||
**Stromal nuclear pleomorphism - | **Stromal nuclear pleomorphism - usually low grade. | ||
**WHO criteria: 2+ mitoses / 10 HPF -- definition suffers from [[HPFitis]]. | **WHO criteria: 2+ mitoses / 10 HPF -- definition suffers from [[HPFitis]]. | ||
***Mitotic rate criteria often ignored as mitotically inactive tumour metastasize. | |||
*Benign glands with an abnormal shape. | *Benign glands with an abnormal shape. | ||
*"Cambium layer" = increased cellularity around the epithelial elements.<ref name=pmid20179434/><ref name=medilexicon_cambium/> | *"Cambium layer" = increased cellularity around the epithelial elements.<ref name=pmid20179434/><ref name=medilexicon_cambium/> | ||