Abstract
Malignant mixed mullerian tumors (MMMT) are unusual neoplasms occurring mostly
in the uterus. In the ovary, they are very rare and represent fewer than 1% of
all ovarian malignancies; in the salpinx, they are even rarer than those of the
ovary. We report a carcinosarcoma of the left adnexa having features of
neuroendocrine differentiation in a 69-year-old female. The tumor contained both
adenocarcinoma and squamous cell carcinoma having dear cell change admixed with
an undifferentiated malignant mesenchymal component. The sarcoma components
consisted of spindle cells, small-round cells and bizarre giant cells mimicking
rhabdomyoblast. Almost all of the carcinomatous glandular components and some
foci of the squamous cell and undifferentiated carcinomatous components were
focal positive for S-100 protein, chromogranin, neuron specific enolase,
synaptophysin and Leu-7. Electron microscopy revealed membrane-bound
neurosecretory granules in the cytoplasm of some glandular epithelial cells.
Histologically, the tumor involved the left adnexa, abdominal peritoneum,
surface of the bladder dome, omentum and left external iliac lymph node (stage
IIIc).