Table 1.

Clinicopathologic features of adenosarcomas arising from adenomyosis

Case No. (ref No.)	Clinical feature	Pathology	Treatment	Outcome	Remarks
1 [15]	Age: 51 yr	Size: 4 cm	Unknown	Unknown	-
	Gyn hx: unknown	Location: lateral wall of the uterine body
	Clinical sign: unknown	Micro:
		Glands with no epithelial cell atypia
		Sarcomatous component with cell pleomorphism and a high mitotic count
		Accompanied by adenomyosis
	Tumor marker: unknown
2 [13]	Age: 20 yr	Size: unknown	Hysterectomy	Two years after surgery, no evidence of recurrent disease	Stromal overgrowth
	Gyn hx: null	Location: right anterolateral portion
	Clinical sign: a longstanding history of menorrhagia and vaginal bleeding	Micro:
		Florid adenomyosis with extensive myometrial invasion, expansile growth within the myometrium, and intravascular invasion in the myometrium
	Tumor marker: β-hCG 50–80 mIU/mL
3 [2]	Age: 46 yr	Size: unknown	Myomectomy	Unknown	-
	Gyn hx: para 1	Location: subserosal mass arising from the posterior surface of the uterus	Additional TAH, BSO, and bilateral pelvic lymphadenectomy
	Clinical sign: vaginal bleeding	Micro:
		Adenomyoma with focal predominant endometrial stroma and periglandular cuffs
		Endometrial stromal cells in the periglandular cuffs showing mild and focal moderate cytological atypia with sparse mitotic figures, including an occasional atypical form
	Tumor marker: unknown
4 [5]	Age: 38 yr	Size: 1.5 cm	Exploratory laparotomy, TAH, LSO, and omentectomy	Disease-free 30 mo after treatment	Heterologous element (rhabdomyosarcoma)
	Gyn hx: gravida 1, para 0	Location: right cornual area	Adjuvant cisplatin, ifosfamide, and mesna
	Clinical sign: chronic pelvic pain and dysmenorrhea	Micro:	5,500 cGy to the abdominal wall
		Irregular glands with benign epithelium surrounded by a hypercellular spindle cell stroma showing rare mitoses, mild nuclear hyperchromasia, and pleomorphism
	Tumor marker
	CEA and AFP: normal
	CA125: 45 U/mL
5 [10]	Age: 52 yr	Size: uncheckable (no distinct mass formation)	Radical hysterectomy with BSO and lymph node dissection and debulking of the pelvic mass	Unknown	Extrauterine pelvic mass (19 cm in diameter) diagnosed as adenosarcoma with rhabdomyosarcomatous differentiation and stromal overgrowth
	Gyn hx: gravida 3, para 3	Location: uterine fundus
	Peri-menopausal	Micro:
		Diffuse adenomyosis with focal stromal expansion, consisting of a hypercellular proliferation of moderately atypical spindle cells with mitotic activity around benign endometrial glands and infiltrating the anterior myometrium
	Clinical sign: none
	Tumor marker
	CA125: 258 U/mL
6 [14]	Age: 53 yr	Size: unknown	Unknown	Unknown	Developed breast carcinoma and received adjuvant chemotherapy including tamoxifen
	Gyn hx: unknown	Location: unknown
	Clinical sign: unknown	Micro:
		Uterine adenosarcoma following an adenomyoma
	Tumor marker: unknown
7	7 Age: 40 yr	Size: 7.5 cm	Laparoscopically assisted TVH	No evidence of recurrence to date	This case
	Gyn hx: gravida 2, para 2	Location: uterine fundus	Additional BSO
	Clinical sign: sudden-onset suprapubic pain and initial low back pain	Micro:
		Dilated glandular elements and abundant, hypercellular stromal elements
		Expansile growth within the myometrium with extensive myometrial invasion and focal infiltration with expansile margin into the subserosa
		Focal involvement of adenomyosis
	Tumor marker
	CA125: 5,000 U/mL
	CA19-9: 39 U/mL
	β-hCG, AFP: normal

Gyn Hx, gynecological history; hCG, human chorionic gonadotropin; Micro, microscopic findings; TAH, total abdominal hysterectomy; BSO, bilateral salpingooophorectomy; LSO, left salpingo-oophorectomy; CEA, carcinoembryonic antigen; AFP, α-fetoprotein; CA, carbohydrate antigen; TVH, total vaginal hysterectomy.