Malignant mixed mullerian tumor:

Abstract

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.