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Abstract
Malignant mixed mullerian tumors (MMMTs) are a rare uterine tumor and contribute to approximately 1-3% of all corpus malignant tumors. MMMTs are usually in the uterine corpus, but can also arise from the uterine cervix, vagina, ovaries and fallofian tubes. MMMTs of the uterine cervix are extremely rare. MMMTs are highly malignant and tend to maintain a rapid growth and exhibit a high rate of recurrence. Therefore, the prognosis of patients diagnosed with these types of tumors is extremely poor. We report a rare case of a malignant mixed mullerian tumor arising from the uterine cervix and introduce CT and MRI findings. CT and magnetic resonance findings of the uterine cervical MMMT in our case show highly aggressive features, such as parametrial involvement, pelvic and paraaortic lymphadenopathy, and distant metastasis and high enhancement.
Figures and Tables
Fig. 1
Imaging and pathologic findings of 54-year-old woman with uterine cervical MMMT.
A. Sagittal T2 weighted image demonstrates large lobulated mass with Heterogenous slightly high signal intensity at the uterine cervix.
B. On axial T2 weighted image, low signal intensity cervical stoma is not visible. Right periureteric parametrial invasion and right hydroureter are also noted (arrow).
C. Gadolinium enhanced T1 weighted image shows strong enhancement of the mass and the epicenter of mass is located at the uterine cervix (arrow).
D. Contrast enhanced axial CT scan demonstrates highly enhanced uterine cervical mass.
E. On delayed scan, right hydronephrosis and metastatic paraaortic lymph nodes are identified.
F. Low attenuation metastatic nodule in liver is also noted (arrow).
G. On PAS staining (× 20), several cytoplasmic staining are identified (arrow).
H, I. The specimen shows high positivity on CEA (× 20) (H), and vimentin (× 20) (I) staining.
Note.-CEA = carcinoembryonic antigen, MMMT = malignant mixed mullerian tumor, PAS = Periodic Acid-Shiff
References
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