Adenosarcoma mulleri associated with tamoxifen use after breast cancer therapy: A case report

Abstract

© 2016, University of Kragujevac, Faculty of Science, All rights reserved. The term ‘mixed Müllerian tumour’ applies to uterine tumours composed of epithelial and mesenchymal elements of Müllerian origin. These neoplasms are classified into adenomyomas, adenofibromas, adenosarcomas, and carcinosarcomas (malignant Müllerian mixed tumours) based on whether the epithelial and stromal elements are benign or malignant. Adenosarcomas are low-grade neoplasms classified halfway along the spectrum of mixed Müllerian tumours, with adenofibromas at one end and carcinosarcomas (malignant Müllerian mixed tumours) at the other. Adenosarcoma is a mixed Müllerian tumour composed of benign appearing but neoplastic glandular elements and a sarcomatous stroma, which is usually low grade. Histologically, there are heterologous mesenchymal elements (usually rhabdomyosarcoma, but also cartilage, fat, and other elements) in 20–25% of cases. We have observed that some women with these tumours have received tamoxifen treatment for breast cancer or have a history of radiation therapy. We herein report the case of a 46-year-old patient who was hospitalized at OGC CC Kragujevac because of excessive bleeding from the uterus. The patient had undergone right mastectomy three years earlier for breast cancer. After surgery, she had received Nolvadex (tamoxifen) treatment. Exploratory curettage was performed, and then, a classic abdominal hysterectomy with bilateral adnexectomy was completed. The histopathological findings indicated adenosarcoma Mülleri; therefore, the patient received postoperative radiation therapy according to our current protocol.