Uterine Adenosarcoma: Histological Aspects and Literature Review

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Austin J Pathol Lab Med. 2020; 7(1): 1027.

Uterine Adenosarcoma: Histological Aspects and Literature Review

Chadi F1,2*, Rouas L1,2 and Lamalmi N1,2

1Department of Gynecological and Pediatric Pathology, IbnSina University Hospital of Rabat, Morocco

2Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Morocco

*Corresponding author: Chadi F, Department of Gynecological and Pediatric Pathology, IbnSina University Hospital, Mohammed V University of Rabat; Villa 42 Al-Mountalak II Rue Al-Bahr Al-Aswad CYM Rabat, Morocco

Received: June 17, 2020; Accepted: July 15, 2020; Published: July 22, 2020


Uterine adenosarcoma is an uncommon tumor that represents 8% of uterine sarcomas. It consists of a double component; a benign component made of a proliferative epithelium and a malignant component represented by a sarcomatous stroma. Its prognosis is relatively favorable after a total hysterectomy with bilateral annexectomy. The objective of this work is to report the histological aspects of uterine adenosarcoma discovered on anatomopathological examination of a polyploid formation delivered by the cervix.

Keywords: Adenosarcoma; Histology; Sarcoma; Uterus 


Uterine sarcomas represent less than 3% of malignant tumors of the female genital tract, including adenosarcoma, which represents 8%. It is a rare subtype of mixed epithelial and mesenchymal malignant tumor. Clinically, the symptomatology is polymorphic dominated by metrorrhagia. Surgery is the basis for the treatment of localized forms. Only the anatomopathological examination allows the positive diagnosis.


We report the observation of a 41-year-old patient, smoking and chronic alcoholic, appendectomy, having two vaginal deliveries, who presents for metrorrhagia. The hysteroscopy shows a polyploid formation delivered by the cervix measuring 5x6 cm.

Macroscopic examination showed several fragments weighing 76g and measuring between 1.5 and 4x3 cm in non-friable soft consistency.

Microscopic examination shows a mixed mesenchymal tumor made of a malignant stroma showing a papillary architecture made up of papillae composed of a stroma of variable cell density more pronounced in the subepithelial, giving a leafy appearance reminiscent of a phyllode tumor (Figure 1,2). This stroma contains mesenchymal cells showing moderate cytonuclear atypia with some rare images of mitosis and includes some rare regular endometrial glands and thick-walled vessels (Figure 3,4). The fragments are most often ulcerated on the surface or lined with an endometrial epithelium showing focal immature tubal, mucinous or squamous metaplasia (Figure 5, 6). On a fragment, there is a broad base for implantation of the polyp and a superficial infiltration of the myometrial tissue (Figure 7).