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Uterine Adenosarcoma
Douglas Rogers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Müllerian adenosarcoma 
            • Subtype of mixed epithelial-mesenchymal tumors, possibly spectrum with adenosarcoma as intermediate malignant potential
              • Adenofibroma: Benign epithelial and mesenchymal components
              • Adenosarcoma: Benign epithelial and malignant mesenchymal components
              • Carcinosarcoma: Malignant epithelial and mesenchymal components

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Lugo Santiago N et al: Management and survival of patients with mullerian adenosarcoma of the cervix without sarcomatous overgrowth desiring fertility preservation, a case report and review of the literature. Gynecol Oncol Rep. 32:100525, 2020
                                          2. Huang YT et al: Current status of magnetic resonance imaging in patients with malignant uterine neoplasms: a review. Korean J Radiol. 20(1):18-33, 2019
                                          3. Kudela E et al: Mullerian adenosarcomas of the uterine cervix with sarcomatous overgrowth. Curr Probl Cancer. 43(4):371-6, 2019
                                          4. Parra-Herran C et al: Uterine mesenchymal tumors: update on classification, staging, and molecular features. Surg Pathol Clin. 12(2):363-96, 2019
                                          5. Vilches Jimenez JC et al: Diagnostic challenges: low-grade adenosarcoma on deep endometriosis. BMC Womens Health. 19(1):124, 2019
                                          6. Yuan Z et al: Uterine adenosarcoma: a retrospective 12-year single-center study. Front Oncol. 9:237, 2019
                                          7. Nathenson MJ et al: Prognostic factors for uterine adenosarcoma: a review. Expert Rev Anticancer Ther. 18(11):1093-100, 2018
                                          8. Nathenson MJ et al: The importance of lymphovascular invasion in uterine adenosarcomas: analysis of clinical, prognostic, and treatment outcomes. Int J Gynecol Cancer. 28(7):1297-310, 2018
                                          9. Ulrich UA et al: Uterine adenosarcoma. Oncol Res Treat. 41(11):693-6, 2018
                                          10. Nathenson MJ et al: Uterine Adenosarcoma: a review. Curr Oncol Rep. 18(11):68, 2016
                                          11. Pinto A et al: Uterine adenosarcoma. Arch Pathol Lab Med. 140(3):286-90, 2016
                                          12. Seagle BL et al: Survival of women with mullerian adenosarcoma: a National Cancer Data Base study. Gynecol Oncol. 143(3):636-41, 2016
                                          13. Chin PS et al: Diagnosis and management of müllerian adenosarcoma of the uterine cervix. Int J Gynaecol Obstet. 121(3):229-32, 2013
                                          14. Hirschowitz L et al: Intravascular adenomyomatosis: expanding the morphologic spectrum of intravascular leiomyomatosis. Am J Surg Pathol. 37(9):1395-400, 2013
                                          15. Lee TY et al: Synchronous occurrence of primary malignant mixed müllerian tumor in ovary and uterus. Obstet Gynecol Sci. 56(4):269-72, 2013
                                          16. Novetsky AP et al: Management of sarcomas of the uterus. Curr Opin Oncol. 25(5):546-52, 2013
                                          17. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                          18. Tanner EJ et al: Management of uterine adenosarcomas with and without sarcomatous overgrowth. Gynecol Oncol. 129(1):140-4, 2013
                                          19. Tirumani SH et al: Current concepts in the imaging of uterine sarcoma. Abdom Imaging. 38(2):397-411, 2013
                                          20. Yu J et al: [Clinicopathologic characteristics of müllerian adenosarcoma of uterus:a comparative analysis of 7 cases before and after surgery.] Zhonghua Bing Li Xue Za Zhi. 42(8):547-8, 2013
                                          21. Akhavan A et al: Uterine adenosarcoma in a patient with history of breast cancer and long-term tamoxifen consumption. BMJ Case Rep. 2012, 2012
                                          22. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                          23. Sameshima N et al: So-called 'adenosarcoma' of the kidney a novel adult renal tumor with a cystic appearance. Pathol Int. 61(5):313-8, 2011
                                          24. Yoshizako T et al: MR imaging of uterine adenosarcoma: case report and literature review. Magn Reson Med Sci. 10(4):251-4, 2011
                                          25. Takeuchi M et al: Adenosarcoma of the uterus: magnetic resonance imaging characteristics. Clin Imaging. 33(3):244-7, 2009
                                          26. Soh E et al: Magnetic resonance imaging findings of tamoxifen-associated uterine müllerian adenosarcoma: a case report. Acta Radiol. 49(7):848-51, 2008
                                          27. Tjalma WA et al: Mullerian adenosarcoma of the uterus associated with long-term oral contraceptive use. Eur J Obstet Gynecol Reprod Biol. 119(2):253-4, 2005
                                          28. Crade M et al: Pedicle sign and diagnosis of endometrial adenosarcoma. J Ultrasound Med. 23(9):1217-9, 2004
                                          29. Lee EJ et al: Polypoid adenomyomas: sonohysterographic and color Doppler findings with histopathologic correlation. J Ultrasound Med. 23(11):1421-9; quiz 1431, 2004
                                          30. Tinar S et al: Adenosarcoma of the uterus: a case report. MedGenMed. 6(1):51, 2004
                                          31. Chourmouzi D et al: Sonography and MRI of tamoxifen-associated mullerian adenosarcoma of the uterus. AJR Am J Roentgenol. 181(6):1673-5, 2003
                                          32. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                          33. Hann LE et al: Sonohysterography for evaluation of the endometrium in women treated with tamoxifen. AJR Am J Roentgenol. 177(2):337-42, 2001
                                          34. Krivak TC et al: Uterine adenosarcoma with sarcomatous overgrowth versus uterine carcinosarcoma: comparison of treatment and survival. Gynecol Oncol. 83(1):89-94, 2001
                                          35. Arici DS et al: Mullerian adenosarcoma of the uterus associated with tamoxifen therapy. Arch Gynecol Obstet. 264(2):105-7, 2000
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Müllerian adenosarcoma 
                                                    • Subtype of mixed epithelial-mesenchymal tumors, possibly spectrum with adenosarcoma as intermediate malignant potential
                                                      • Adenofibroma: Benign epithelial and mesenchymal components
                                                      • Adenosarcoma: Benign epithelial and malignant mesenchymal components
                                                      • Carcinosarcoma: Malignant epithelial and mesenchymal components

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Lugo Santiago N et al: Management and survival of patients with mullerian adenosarcoma of the cervix without sarcomatous overgrowth desiring fertility preservation, a case report and review of the literature. Gynecol Oncol Rep. 32:100525, 2020
                                                                                  2. Huang YT et al: Current status of magnetic resonance imaging in patients with malignant uterine neoplasms: a review. Korean J Radiol. 20(1):18-33, 2019
                                                                                  3. Kudela E et al: Mullerian adenosarcomas of the uterine cervix with sarcomatous overgrowth. Curr Probl Cancer. 43(4):371-6, 2019
                                                                                  4. Parra-Herran C et al: Uterine mesenchymal tumors: update on classification, staging, and molecular features. Surg Pathol Clin. 12(2):363-96, 2019
                                                                                  5. Vilches Jimenez JC et al: Diagnostic challenges: low-grade adenosarcoma on deep endometriosis. BMC Womens Health. 19(1):124, 2019
                                                                                  6. Yuan Z et al: Uterine adenosarcoma: a retrospective 12-year single-center study. Front Oncol. 9:237, 2019
                                                                                  7. Nathenson MJ et al: Prognostic factors for uterine adenosarcoma: a review. Expert Rev Anticancer Ther. 18(11):1093-100, 2018
                                                                                  8. Nathenson MJ et al: The importance of lymphovascular invasion in uterine adenosarcomas: analysis of clinical, prognostic, and treatment outcomes. Int J Gynecol Cancer. 28(7):1297-310, 2018
                                                                                  9. Ulrich UA et al: Uterine adenosarcoma. Oncol Res Treat. 41(11):693-6, 2018
                                                                                  10. Nathenson MJ et al: Uterine Adenosarcoma: a review. Curr Oncol Rep. 18(11):68, 2016
                                                                                  11. Pinto A et al: Uterine adenosarcoma. Arch Pathol Lab Med. 140(3):286-90, 2016
                                                                                  12. Seagle BL et al: Survival of women with mullerian adenosarcoma: a National Cancer Data Base study. Gynecol Oncol. 143(3):636-41, 2016
                                                                                  13. Chin PS et al: Diagnosis and management of müllerian adenosarcoma of the uterine cervix. Int J Gynaecol Obstet. 121(3):229-32, 2013
                                                                                  14. Hirschowitz L et al: Intravascular adenomyomatosis: expanding the morphologic spectrum of intravascular leiomyomatosis. Am J Surg Pathol. 37(9):1395-400, 2013
                                                                                  15. Lee TY et al: Synchronous occurrence of primary malignant mixed müllerian tumor in ovary and uterus. Obstet Gynecol Sci. 56(4):269-72, 2013
                                                                                  16. Novetsky AP et al: Management of sarcomas of the uterus. Curr Opin Oncol. 25(5):546-52, 2013
                                                                                  17. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                                                                  18. Tanner EJ et al: Management of uterine adenosarcomas with and without sarcomatous overgrowth. Gynecol Oncol. 129(1):140-4, 2013
                                                                                  19. Tirumani SH et al: Current concepts in the imaging of uterine sarcoma. Abdom Imaging. 38(2):397-411, 2013
                                                                                  20. Yu J et al: [Clinicopathologic characteristics of müllerian adenosarcoma of uterus:a comparative analysis of 7 cases before and after surgery.] Zhonghua Bing Li Xue Za Zhi. 42(8):547-8, 2013
                                                                                  21. Akhavan A et al: Uterine adenosarcoma in a patient with history of breast cancer and long-term tamoxifen consumption. BMJ Case Rep. 2012, 2012
                                                                                  22. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                                                                  23. Sameshima N et al: So-called 'adenosarcoma' of the kidney a novel adult renal tumor with a cystic appearance. Pathol Int. 61(5):313-8, 2011
                                                                                  24. Yoshizako T et al: MR imaging of uterine adenosarcoma: case report and literature review. Magn Reson Med Sci. 10(4):251-4, 2011
                                                                                  25. Takeuchi M et al: Adenosarcoma of the uterus: magnetic resonance imaging characteristics. Clin Imaging. 33(3):244-7, 2009
                                                                                  26. Soh E et al: Magnetic resonance imaging findings of tamoxifen-associated uterine müllerian adenosarcoma: a case report. Acta Radiol. 49(7):848-51, 2008
                                                                                  27. Tjalma WA et al: Mullerian adenosarcoma of the uterus associated with long-term oral contraceptive use. Eur J Obstet Gynecol Reprod Biol. 119(2):253-4, 2005
                                                                                  28. Crade M et al: Pedicle sign and diagnosis of endometrial adenosarcoma. J Ultrasound Med. 23(9):1217-9, 2004
                                                                                  29. Lee EJ et al: Polypoid adenomyomas: sonohysterographic and color Doppler findings with histopathologic correlation. J Ultrasound Med. 23(11):1421-9; quiz 1431, 2004
                                                                                  30. Tinar S et al: Adenosarcoma of the uterus: a case report. MedGenMed. 6(1):51, 2004
                                                                                  31. Chourmouzi D et al: Sonography and MRI of tamoxifen-associated mullerian adenosarcoma of the uterus. AJR Am J Roentgenol. 181(6):1673-5, 2003
                                                                                  32. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                                                                  33. Hann LE et al: Sonohysterography for evaluation of the endometrium in women treated with tamoxifen. AJR Am J Roentgenol. 177(2):337-42, 2001
                                                                                  34. Krivak TC et al: Uterine adenosarcoma with sarcomatous overgrowth versus uterine carcinosarcoma: comparison of treatment and survival. Gynecol Oncol. 83(1):89-94, 2001
                                                                                  35. Arici DS et al: Mullerian adenosarcoma of the uterus associated with tamoxifen therapy. Arch Gynecol Obstet. 264(2):105-7, 2000