Extragenital Müllerian Adenosarcoma in the Pouch of Douglas
Extragenital Müllerian Adenosarcoma in the Pouch of Douglas
Background:Extragenital Müllerian adenosarcomas areextremelyraretumours characterised bya stromal component oflow-grade ma-lignancy and by a benign glandular epithelial component.Case Report:A 26-year-old woman wasadmitted toourclinic be-cause oflower abdominal distension andleftlower quadrant pain. Clinical andradiological examinations suggested anovarian malig-nancy. Laparotomy revealed a cystic mass inthepouch ofDouglas,originating fromtheleftsacrouterine ligament. A totalexcision of the tumour wasperformed andshowed low-grade adenosarcoma withoutsarcomatous overgrowth. Follow-up at24months afterthesurgeryshowed no evidence of recurrence.Conclusion:Mullerian adenosarcoma located in thepouch of Douglasis rare.Fortreatment, success maybeachieved withonlyexcision of thetumour if thereis nosarcomatous overgrowth or spread to adjacenttissues.
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- Clement PB, Scully RE. Müllerian adenosarcoma of the uterus. A clin- icopathologic analysis of ten cases of a distinctive type of Müllerian mixed tumor. Cancer 1974;34:1138-49. [CrossRef]
- Inoue M, Fukuda H, Tanizawa O. Adenosarcomas originating from sites other than uterine endometrium. Int J Gynaecol Obstet 1995;48: 299-306. [CrossRef]
- Visvalingam S, Jaworski R, Blumenthal N, Chan F. Primary peritoneal mesodermal adenosarcoma: report of a case and review of the literature. Gynecol Oncol 2001;81:500-5. [CrossRef]
- Toyoshima M, Akahira J, Moriya T, Hayakawa S, Yaegashi N. Primary vaginal adenosarcoma with sarcomatous overgrowth. Gynecol Oncol 2004;95:759-61. [CrossRef]
- Ostör AG, Nirenberg A, Ashdown ML, Murphy DJ. Extragenital adeno- sarcoma arising in the pouch of Douglas. Gynecol Oncol 1994;53:373-5. [CrossRef]
- Patrelli TS, Silini EM, Gizzo S, Berretta R, Franchi L, Thai E, et al. Extragenital Müllerian adenosarcoma with pouch of Douglas location. BMC Cancer 2011;15;11:171.
- Clement PB, Scully RE. Extra uterine mesodermal (müllerian) adenosarcoma:a clinicopathologic analysis of five cases. Am J Clin Pathol 1978;69:276-83.
- Murugasu A, Miller J, Proietto A, Millar E. Extragenital Mullerian adenosar- coma with sarcomatous overgrowth arising in an endometriotic cyst in the pouch of Douglas. Int J Gynecol Cancer 2003;13:371-5. [CrossRef]
- Chang HY, Changchien CC, Chen HH, Lin H, Huang CC. Extrauterine Mullerian adenosarcoma associated with endometriosis and rectal vil- lotubular adenoma: report of a case and review of the literature. Int J Gynecol Cancer 2005;15:361-5. [CrossRef]
- Huang GS, Arend RC, Sakaris A, Hebert TM, Goldberg GL. Extrageni- tal adenosarcoma:A case report, review of the literature, and manage- ment discussion. Gynecol Oncol 2009;115:472-5. [CrossRef]
- Douglas GW, Kastin AJ, Huntington RW. Carcinoma arising in a retro- peritonel Mullerian cyst with widespread metastases during pregnancy. Am J Obstet Gynecol 1965;91:210-6.
- Bard E, Bard D, Vargas-Cortez F. Extrauterine Mullerian Adenosarco- ma. A clinicopathologic report of a case with distant metastases and a review of the literature. Gynecol Oncol 1978;6:271-4. [CrossRef]
- Kao GF, Norris HJ. Benign and low grade variants of mixed mesoder- mal tumour (6. adenosarcoma) of the ovary and adnexal region. Cancer 1978;42:1314-24. [CrossRef]
- Russel P, Slavutin R, Laverty CR, Cooper J. Extrauterine mesodermal (Mul- lerian) adenosarcoma. A case report. Pathology 1979;11:557-60.[CrossRef]
- Vara AR, Ruzics EP, Moussabeck O, Martin DC. Endometroid adenosar- coma of the bladder arising from endometriosis. J Urol 1990;143:813-5.
- Roman LD, Mitchell MF, Tornos C, Glaver B, Kavanagh JJ. Dedifferen- tiated extrauterine adenosarcoma responsive to chemotherapy. Gynecol Oncol 1993;49:389-94. [CrossRef]
- Kerner H, Lichtig C, Beck D. Extrauterine Mullerian adenosarcoma of the peritoneal mesothelium:a clinicopatholigic and electron microscopic study. Obstet Gynecol 1989;73:510-3.
- De Jonge MJ, Van Dam PA, Van Marck E, Prove A, Van Oosterom AT. Primary extrauterine Mullerian adenosarcoma of the peritoneum. Gyne- col Oncol 1995;57:126-30. [CrossRef]
- Kato N, Zhe J, Endoh Y, Motoyama T. Extrauterine Mullerian adeno- sarcoma of the peritoneum with an extensive rhabdomyosarcomatous element and a marked myxoid change. Pathol Int 2000;50:347-51 [CrossRef]