T. Kaku et al., ADENOSARCOMA OF THE UTERUS - A GYNECOLOGIC ONCOLOGY GROUP CLINICOPATHOLOGICAL STUDY OF 31 CASES, International journal of gynecological pathology, 11(2), 1992, pp. 75-88
We report on the clinical and pathologic findings in 31 cases of adeno
sarcoma of the uterus subjected to hysterectomy and staging laparotomy
. Nine of 30 patients (30%) have had recurrent tumor and six of 30 (20
%) have already died of tumor in a relatively short follow-up period (
mean, 38.3 months). Seventeen of 31 cases were diagnosed as adenosarco
ma with sarcomatous overgrowth (SO). Ten of these 17 with SO contained
focal or extensive rhabdomyosarcoma. In six cases, extrauterine sprea
d was identified as follows (two patients had two sites each): vaginal
involvement (two cases), pelvic lymph node metastases (two), positive
peritoneal cytologic findings (two), parametrial invasion (one), and
ovarian metastasis (one). Extrauterine spread (stage III) (p < 0.001)
and myometrial invasion (p = 0.04) were associated with higher rates o
f recurrence. The presence of lymphatic and/or vascular invasion, SO,
and rhabdomyosarcomatous differentiation also indicated poor prognosis
but did not attain statistical significance. Based on this experience
, staging laparotomy including peritoneal cytology is suggested in cas
es of clinical stages I and II adenosarcoma. The differential diagnosi
s of these tumors is also discussed.