Late recurrence of uterine Mullerian adenosarcoma as heterologous sarcoma: Three recurrences in 8 months increasing in number and grade of sarcomatous components.

BACKGROUND: Uterine Mullerian adenosarcoma (UMA) is a rare and low-grade variant of mixed mesodermal tumor. UMA recurrences including heterologous sarcomatous elements are extremely rare, with only 3 cases reported thus far. CASE: We present a case of UMA recurring as heterologous sarcoma three times in 8 months for 9.4 years after primary treatment. The number and grade of sarcomatous components increased with each recurrence eventually resulting in loss of the patient. CONCLUSION: The presence of multiple sarcomatous elements of high histological grade in the recurrent tumor following UMA may indicate an unfavorable prognosis with common recurrences and fatal outcome. All UMA patients carry risk of late recurrence, therefore, they should receive long-term follow-up.

Metachronous metastases from renal cell carcinoma to uterine cervix and vagina: case report and review of literature.

BACKGROUND: Although renal cell carcinoma (RCC) is characterized with unpredictable clinical presentation, multiple genital tract metastases are still surprising and mode of spread is obscure. CASE: We report a case of RCC metastases to uterine cervix and vagina 1 year after radical nephrectomy in a 19-year-old virgin. To our knowledge, this case is the second youngest patient with RCC metastasis to vagina, and also third patient with RCC metastasis to uterine cervix. CONCLUSION: Detection of genital lesion may precede diagnosis of RCC. The primary renal tumor was mostly left sided. Retrograde venous extension seems to be the most plausible mode of spread. Limited total experience and variability in therapeutic approach prevent generalizations regarding prognosis, optimal treatment and survival.

Intracavitary cardiac metastasis and pulmonary tumor emboli of choriocarcinoma: the first case diagnosed and treated without surgical intervention.

BACKGROUND: Choriocarcinoma mostly metastasizes to lung parenchyma. Its pulmonary tumor embolism and cardiac metastasis are very rarely encountered, of which antemortem diagnosis is even more rare. CASE: To our knowledge, we present the first case of intracavitary cardiac metastasis and pulmonary tumor emboli of choriocarcinoma diagnosed and treated without any surgical intervention. Multi-agent chemotherapy led to almost complete regression of cardiac and pulmonary lesions and normalization of beta-hCG levels. CONCLUSION: Cardiac metastasis of choriocarcinoma must be kept in mind for cases of cardiac mass in reproductive age women, especially when history and clinical presentation are suggestive for gestational trophoblastic disease. As the tumor is highly sensitive, chemotherapy together with biochemical and radiological monitoring constitutes an effective treatment modality if cardiopulmonary functions are not deteriorating.