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Yi, Jung, Seong, Kim, Kim, Yoon, Song, and Shim: Malignant mixed Müllerian tumor of uterine cervix: A case of very poor prognosis
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2012; 55(12): 990-995.

Published online: 18 December 2012

DOI: https://doi.org/10.5468/KJOG.2012.55.12.990

Malignant mixed Müllerian tumor of uterine cervix: A case of very poor prognosis

Hyo-Jin Yi, MD1, Yong-Wuk Jung, MD1, Seok Ju Seong, MD, PhD1, Mi Kyoung Kim, MD1, Mi-La Kim, MD1, Bo-Sung Yoon, MD1, Taejong Song, MD1, Jeong Yun Shim, MD2

1Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

2Department of Pathology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

Corresponding author: Seok-Ju Seong, MD, PhD. Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 566 Nonhyeon-ro, Gangnam-gu, Seoul 135-913, Korea. Tel: +82-2-3468-3672, Fax: +82-2-3468-2638, sjseongcheil@yahoo.co.kr

Received 21 February 2012       Revised 26 July 2012       Accepted 31 July 2012

Copyright © 2012. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malignant mixed Müllerian tumor (MMMT) is a type of cancer that contains two cell types known as the adenocarcinoma and sarcoma. MMMT is a rare malignant cancer of the genital tract and particularly the prevalence of MMMT in the cervix is extremely rare. Due to the rare incidence of MMMT in cervix, its treatment has unestablished guidelines and has unclear prognosis. Based on the previous data, the prognosis of MMMT in the cervix is better than the prognosis of uterine MMMT. Here, we are reporting a case of cervix MMMT that is rapidly progressive with an extremely poor prognosis, which contradicts the previous data.

Keywords: Malignant mixed Müllerian tumor, Uterine cervix, Prognosis

Figures and Tables

Fig. 1
Magnetic resonance imaging finding. 2.6 × 3.4 × 3.0 cm sized enhancing cervical mass.
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Fig. 2
In the uterine cervix and the lower segment of the uterus, a beige colored, 5.4 × 3 cm sized solid mass with ill-defined boundaries is observed.
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Fig. 3
The epithelial cell component is mostly composed of undifferentiated carcinoma cells (A, H&E, ×200) and the stromal cell component is mainly composed of undifferentiated sarcoma cells (B, H&E, ×200). Pleomorphism and mitosis is observed in both of the components which is consistent with malignant mixed Müllerian tumor.
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Fig. 4
Adenosquamous cell carcinoma, undifferentiated sarcoma and chondylosarcoma are partly observed (A, H&E, ×200). After immunohistochemical stain adenosquamous cell carcinoma was cytokeratin positive (B, cytokeratin, ×200) and undifferentiated sarcoma and chondylosarcoma was vimentin positive (C, vimentin, ×200).
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Fig. 5
Abdominopelvic computed tomography images 1 month after operation. Metastatic masses were found at liver, pelvic cavity, and multiple lymph nodes. Also, right hydronephrosis and hydroureter were checked.
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Fig. 6
Preoperative and postoperative positron emission tomography-computed tomography (PET-CT) findings. (A) Preoperative PET-CT images. (B) Postoperative 1 month later PET-CT images.
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Table 1
The prognosis of cervical MMMT
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3MMMT, malignant mixed Mullerian tumor; DOD, died of disease; NED, no evidence of disease; RH, radical hysterectomy; BPLND, bilateral pelvic lymphadenectomy; BSO, bilateral salpingo-oophorectomy; BPALND, bilateral para-aortic lymphadenectomy.

aPatient 2 died of myocardial infarction with no evidence of cervical disease; bThis case.

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