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Mullerian adenosarcoma of the uterine cervix misdiagnosed as an endocervical polyp on magnetic resonance imaging and two preoperative consecutive biopsies: A diagnostic challenge

  • Eun Hee Yu1,†
  • Yong Jung Song1,†
  • Seul Yi Lee1
  • Seo Yoon Hwang1
  • Nam Kyung Lee2
  • Kyung Un Choi3
  • Dong Soo Suh1,4
  • Ki Hyung Kim1,4,*,

1Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan 49241, Republic of Korea

2Department of Radiology, Pusan National University School of Medicine, Busan 49241, Republic of Korea

3Department of Pathology, Pusan National University School of Medicine, Busan 49241, Republic of Korea

4Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea

DOI: 10.31083/j.ejgo.2020.06.2095 Vol.41,Issue 6,December 2020 pp.1045-1049

Submitted: 22 March 2019 Accepted: 18 June 2019

Published: 15 December 2020

*Corresponding Author(s): Ki Hyung Kim E-mail: ghkim@pusan.ac.kr

† These authors contributed equally.

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Abstract

Mullerian adenosarcoma of the uterine cervix generally displays cervical polyps and can be often misdiagnosed as benign endocervical polyps both clinically and pathologically. A 52-year-old woman presented with a two-month history of postmenopausal bleeding. Pelvic examination revealed a large polyp-like mass protruding from the cervical ostium. Two preoperative consecutive biopsies showed a histologic diagnosis consistent with an endocervical polyp. Pelvic magnetic resonance imaging (MRI) depicted a lobulated well- en-hancing endocervical mass, suggestive of an endocervical polyp based on the apparent diffusion coefficient (ADC) value. The patient was subjected to total hysterectomy with bilateral salpingectomy. Microscopically, the tumor was composed of epithelial and stromal components. The final pathologic diagnosis was Mullerian adenosarcoma of the cervix. The authors presented an unusual case that demonstrated an endocervical polyp on magnetic resonance imaging and two consecutive biopsies preoperatively.


Keywords

Endocervical polyp; Mullerian adenosarcoma; Uterine cervix.


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Eun Hee Yu, Yong Jung Song, Seul Yi Lee, Seo Yoon Hwang, Nam Kyung Lee, Kyung Un Choi, Dong Soo Suh, Ki Hyung Kim. Mullerian adenosarcoma of the uterine cervix misdiagnosed as an endocervical polyp on magnetic resonance imaging and two preoperative consecutive biopsies: A diagnostic challenge. European Journal of Gynaecological Oncology. 2020; 41(6): 1045-1049. doi: 10.31083/j.ejgo.2020.06.2095

References

[1] Clement P.B., Scully R.E.: “Mullerian adenosarcoma of the uterus: A clinicopathologic analysis of 100 cases with a review of the literature”. Hum. Pathol., 1990, 21, 363-381.

[2] Manoharan M., Azmi M., Soosay G., Mould T., Weekes A.: “Mullerian adenosarcoma of uterine cervix: Report of three cases and review of literature”. Gynecol. Oncol., 2007, 105, 256-260.

[3] Seagle B.L., Kanis M., Strohl A.E., Shahabi S.: “Survival of women with Mullerian adenosarcoma: a national cancer data base study”. Gynecol. Oncol., 2016, 143, 636-641.

[4] Yuan Z., Shen K., Yang J., Cao D., Zhang Y., Zhou H., et al.: “Uter-ine adenosarcoma: a retrospective 12-year single-center study”. Front. Oncol., 2020, 9237.

[5] Grasel R.P., Outwater E.K., Siegelman E.S., Capuzzi D., Parker L., Hussain S.M.: “Endometrial polyps: MR imaging features and distinction from endometrial carcinoma”. Radiology, 2000, 214, 47-52.

[6] Bakir B., Sanli S., Bakir V.L., Ayas S., Yildiz S.O., Iyibozkurt A.C., et al.: “Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening”. Clin. Imaging, 2017, 41, 86-94.

[7] Takeuchi M., Matsuzaki K., Nishitani H.: “Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion”. Acta Radiol., 2009, 50, 947-953.

[8] Hase S., Mitsumori A., Inai R., Takemoto M., Matsubara S., Aka-matsu N., et al.: “Endometrial polyps: MR imaging features”. Acta Med. Okayama, 2013, 66, 475.

[9] Whittaker C.S., Coady A., Culver L., Rustin G., Padwick M., Pad-hani A.R.: “Diffusion-weighted MR imaging of female pelvic tumors: a pictorial review”. Radiographics, 2009, 29, 759-774.

[10] McVeigh P.Z., Syed A.M., Milosevic M., Fyles A., Haider M.A.: “Diffusion-weighted MRI in cervical cancer”. Eur. Radiol., 2008, 18, 1058-1064.

[11] Kuang F., Yan Z., Li H., Feng H.: “Diagnostic accuracy of diffusion-weighted MRI for differentiation of cervical cancer and benign cervical lesions at 3.0T: Comparison with routine MRI and dynamic contrast-enhanced MRI”. J. Magn. Reson. Imaging, 2015, 42, 1094-1099.

[12] Chin P., Chia Y., Lim Y., Yam K.: “Diagnosis and management of Mullerian adenosarcoma of the uterine cervix”. Int. J. Gynaecol. Obstet., 2013, 121, 229-232.

[13] Soslow R.A., Ali A., Oliva E.: “Mullerian adenosarcomas: an immunophenotypic analysis of 35 cases”. Am. J. Surg., 2008, 32, 1013-1021.

[14] Gallardo A., Prat J.: “Mullerian adenosarcoma”. Am. J. Surg., 2009, 33, 278-288.

[15] McCluggage W.G.: “Mullerian adenosarcoma of the female genital tract”. Adv. Anat. Pathol., 2010, 17, 122-129.

[16] Kudela E., Nachajova M., Balharek T., Gabonova E., Danko J.: “Mullerian adenosarcomas of the uterine cervix with sarcomatous overgrowth”. Curr. Probl. Cancer, 2019, 43, 371-376.

[17] Togami S., Kawamura T., Fukuda M., Yanazume S., Kamio M., Kobayashi H.: “Clinical management of uterine cervical mullerian adenosarcoma: a clinicopathological study of six cases and review of the literature”. Taiwan J. Obstet. Gynecol., 2018, 57, 479-482.

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