Vaginal adenosarcoma arising from endometriosis

Objective. Malignant transformation of endometriosis has been well document ed. Endometrioid adenocarcinoma is the most common malignancy to occur in t his setting, although other carcinomas and rarely stromal tumors can be see n. We present the first case in the literature of adenosarcoma, a rare mixe d mullerian or mesodermal tumor, arising in extrauterine vaginal endometrio sis. Case. A 42-year-old woman underwent multiple medical therapies and surgerie s for aggressive endometriosis. A pelvic exenteration was abandoned seconda ry to severe fibrosis, and low-dose radiotherapy was used to control bleedi ng from vaginal endometriosis. The pathologic diagnosis of recurrent endome triosis was confirmed multiple times over her 4-year course. Excision of a recurrent vaginal mass revealed adenosarcoma with heterologous elements. Conclusion. It is important to biopsy or excise recurrent endometriosis, as malignant transformation can occur, giving rise to epithelial, stromal, or mixed epithelial-mesenchymal tumors, (C) 2000 Academic Press.