子宮のＭｕｅｌｌｅｒｉａｎ　ａｄｅｎｏｓａｒｃｏｍａの２例

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  • Muellerian adenosarcoma of the uterus. Report of two cases.

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Two cases of müllerian adenosarcoma of the uterine body are reported. Our report aims at describing the cytologic features of this rare tumor. Patient 1 was a 67-yearold woman who underwent total hysterectomy because of abnormal vaginal bleeding of three months duration. The resected specimen revealed a cauliflower-like tumor (7×7×3 cm) growing into the intrauterine cavity. Patient 2 was a 55-year-old woman with a large intravaginal tumor. The hysterectomy material showed a pedunculated tumor (12×5×6 cm) protruding from the external os of the uterus. The latter patient died of extensive lung metastasis 6 years after surgery. Both cases were histologically diagnosed as adenosarcoma. Preoperative endometrial cytology and imprinting tumor cytology revealed various types of epithelial cells such as endometrial gland-like, cervical gland-like, squamous metaplastic and tissue repair cells, and there were no definite findings of malignancy. As epithelia of müllerian origin are capable of differentiating into various morphological appearances, the possibility of adenosarcoma must be considered when these unusual epithelial cells appear on endometrial cytology in postmenopausal women. Recognition of sarcomatous atypical cells is the key diagnostic finding. Repeat of cytology and biopsy should be performed when numerous clustering interstitial cells are found, because the diagnostic sarcomatous cells may appear only rarely.

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