Mullerian adenosarcoma of the uterus
Adenosarcoma of the uterus is a rare tumor of the uterus that typically originates in the lining of the uterus (endometrium). This type of tumor is characterized by both benign (noncancerous) and malignant components (low-grade sarcoma). Typical symptoms in affected individuals may include abnormal vaginal bleeding, an enlarged uterus, and tissue protruding from the external os (external opening of the uterus that leads into the cavity of the cervix). It is most common in post-menopausal women but can affect women of any age. Factors that may predisposed an individual to the condition include hyperestrogenemia (high blood estrogen levels), chemotherapy, or radiotherapy. Recommended treatment includes hysterectomy, usually accompanied by bilateral salpingo-oophorectomy (removal of fallopian tubes and ovaries). Ovarian conservation is an option for reproductive age women.
Symptoms of adenosarcoma are many and varied, and depend on a variety of patient-specific factors related to cancer type and stage, tumor location and size, and more. Symptoms of adenosarcoma may include the following:
- Experiencing prolonged and unrelieved discomfort
- Discovering a lump in the body
- Asymptomatic in early stages
- Post-menopausal bleeding
- Abnormal vaginal secretions
- Pelvic pain
- Pelvic mass
- Infrequent menstrual periods
- Cessation of menstrual periods
- Pain during sex
- Back pain
- Weight loss
- Bladder symptoms
- Rectal symptoms
- Painful urination
- Pain during bowel movements
Mullerian adenosarcoma (which occurs in a woman's uterus or ovaries) may display similar warning signs to other types of uterine cancer or ovarian cancer. Because these symptoms may be the result of another condition unrelated to adenosarcoma, a medical professional needs make the determination.
The exact cause of adenosarcoma of the uterus is not always known. The development of these tumors has been associated with a few risk factors. Risk factors are associated with an increased risk of developing a condition; however, most people with these risk factors will never develop the condition. Factors that have reportedly been associated with development of adenosarcoma of the uterus include hyperestrinism (abnormally high levels of estrogenic hormones in the body), prior chemotherapy, prior radiotherapy and tamoxifen therapy (used as an adjuvant drug for breast cancer).
The most common presentation is vaginal bleeding. Other presentations include pelvic mass and uterine polyp. Generally, the clinical findings are non-specific.
The prognosis is determined primarily by the cancer stage. Most tumours are discovered at an early stage and have a good prognosis, especially when compared to uterine carcinosarcoma. Five year survival for stage I and stage III tumours is approximately 80% and 50% respectively.
Treatment for adenosarcoma varies based on the cancer type and stage, as well as the patient's age, state of health, personal preferences, and more. Conventional forms of adenosarcoma treatment may include, but are not limited to, surgery, chemotherapy and radiation therapy.
Uterine adenosarcomas are typically treated with a total abdominal hysterectomy and bilateral salpingoophorectomy (TAH-BSO). Ovary sparing surgery may be done in women wishing to preserve fertility.