Giant uterine adenosarcoma with sarcomatous overgrowth: a case report

Introduction:

Uterine sarcomas are a rare group of neoplasms with an aggressive clinical course and a poor prognosis regardless of stage at presentation. The etiology is still unknown. Very few cases of adenosarcoma with sarcomatous overgrowth are reported in the literature.

Case presentation:

A 53 year-old woman was submitted to our hospital with a 3-month history of a rapidly growing abdominal mass and vaginal bleeding. Laboratory studies showed elevated serum Carbohydrate Antigen-125 levels (CA 125) and anemia. Computer tomography (CT) scan presented a big mass arising from the pelvis. The patient underwent an explorative laparotomy with hysterectomy and bilateral salpingo-oophorectomy. The extirpated uterus weighed 5661 grams. Histologically an adenosarcoma with sarcomatous overgrowth was diagnosed. After surgery the patient developed a wound breakdown and a severe pneumonia due to preexisting comorbidities and deceased 6 weeks after the first surgery.

Conclusion:

Adenosarcoma with sarcomatous overgrowth is an aggressive and rare tumor with an unfavourable outcome. Debulking surgery and histological examination are the cornerstone of the diagnosis and therapy. Further investigations are required to determine the risk factors, the pathogenesis of adenosarcoma and the optimal therapy.