Malignant mixed mullerian tumor:
Date
2022-05-20Author
Emmanuel D, Morgan
Tonny, Okecha
James J., Yahaya
Emmanuel, Othieno
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Abstract:
Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which
occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women.
Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal
bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a
hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and
bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient
is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin.
Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers
and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically,
MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal
(sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior
remains undetermined.
Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high
rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy
remains unclear in the management of patients with this tumor. Both stage of the tumor and
myometrial invasion are considered as potential prognostic factors.