Gynecologic oncology reports · 2026
Müllerian adenosarcoma in a young adult: A case report and literature review of diagnostic and management challenges.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Posite Charles Malisaba, Legesse Biruk, Etienne Ndungo, Justine Musubao, Tumwesigire Samuel, Birungi Abraham, Santos Mirna Batista, Ahmed Suleman Essa, Wabinga Henry, Atwine Raymond
Аннотация
BACKGROUND: Müllerian adenosarcoma is a rare biphasic uterine malignancy typically affecting postmenopausal women. Its occurrence in young, nulliparous women is extremely uncommon, presenting diagnostic challenges, especially in cases of presumed recurrences.
CASE PRESENTATION: A 22-year-old nulliparous woman presented with a presumed recurrent, enlarging prolapsing uterine mass and post-coital bleeding. Her history was notable for two prior excisions of a similar mass without histopathological review. Examination revealed a 6 cm friable mass protruding through the cervical os. Given the recurrence and risk of hemorrhage in a resource-limited setting, a total abdominal hysterectomy was performed. Gross examination identified a 9x6x4 cm polypoid mass confined to the fundus. Histopathology confirmed high-grade endometrial adenosarcoma, characterized by classic biphasic features, significant spindle-cell atypia, and a brisk mitotic rate (>10 mitoses/10 HPFs). Immunohistochemistry showed stromal positivity for CD10 and PR. No myometrial invasion or lymphovascular space invasion was observed. The patient remains asymptomatic under a rigorous three-month surveillance protocol.
CONCLUSION: This case highlights a rare high-grade presentation in a young adult. Despite aggressive histological features, the absence of myometrial invasion supports definitive surgery followed by intensive long-term surveillance. This report underscores the necessity of a high index of suspicion for malignancy in recurrent polypoid masses within the reproductive age group and addresses critical gaps regarding fertility preservation and age-specific management protocols.
CASE PRESENTATION: A 22-year-old nulliparous woman presented with a presumed recurrent, enlarging prolapsing uterine mass and post-coital bleeding. Her history was notable for two prior excisions of a similar mass without histopathological review. Examination revealed a 6 cm friable mass protruding through the cervical os. Given the recurrence and risk of hemorrhage in a resource-limited setting, a total abdominal hysterectomy was performed. Gross examination identified a 9x6x4 cm polypoid mass confined to the fundus. Histopathology confirmed high-grade endometrial adenosarcoma, characterized by classic biphasic features, significant spindle-cell atypia, and a brisk mitotic rate (>10 mitoses/10 HPFs). Immunohistochemistry showed stromal positivity for CD10 and PR. No myometrial invasion or lymphovascular space invasion was observed. The patient remains asymptomatic under a rigorous three-month surveillance protocol.
CONCLUSION: This case highlights a rare high-grade presentation in a young adult. Despite aggressive histological features, the absence of myometrial invasion supports definitive surgery followed by intensive long-term surveillance. This report underscores the necessity of a high index of suspicion for malignancy in recurrent polypoid masses within the reproductive age group and addresses critical gaps regarding fertility preservation and age-specific management protocols.