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Diagnosis and management of Müllerian adenosarcoma of the uterine cervix
Author(s) -
Chin PuiSee,
Chia YinNin,
Lim YongKuei,
Yam KwaiLam
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.12.015
Subject(s) - medicine , cervix , hysterectomy , polypectomy , asymptomatic , surgery , vaginal bleeding , stage (stratigraphy) , gynecology , cancer , pregnancy , colorectal cancer , paleontology , colonoscopy , biology , genetics
Objective To report on the diagnosis and management of Müllerian adenosarcoma of the uterine cervix at a gynecologic oncology unit in Singapore. Methods Nine cases (1992–2008) were identified from the unit registry. All hospital records were retrospectively analyzed. Results Mean age at diagnosis was 45 ± 12 years (range, 17–61 years). Presenting symptoms were abnormal vaginal bleeding (5 [55.6%] patients), introital mass (3 [33.3%] patients), and foul‐smelling vaginal discharge (1 [11.1%] patient). Two (22.2%) patients were asymptomatic, with cervical polyps discovered incidentally on routine gynecologic check‐up. All women had benign‐looking cervical polyps and underwent polypectomy. Histology showed increased stromal cellularity with periglandular cuffs in all patients, and heterologous differentiation in 1(11.1%) patient. All 9 women had FIGO stage 1B disease. Seven (77.8%) patients underwent radical hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy. One (11.1%) woman underwent cervical wedge resection and 1 (11.1%) refused definitive surgery. There was no recurrence in the 6 patients for whom complete follow‐up data were available. Conclusion Clinical diagnosis of Müllerian adenosarcoma of the uterine cervix may be challenging owing to the benign gross appearance of the cervical polyps. Surgery provides a good chance of cure with no recurrence.