Primary malignant mixed Müllerian tumors of the fallopian tube with cervix metastasis: A rare case report and literature review.

RATIONALE: Primary malignant mixed mullerian tumors of the fallopian tube is very rare and has only 1 case in the current literature with cervix metastasis. PATIENT CONCERNS: We reported a 49-year-old woman sufferring from primary malignant mixed mullerian tumors of the fallopian tube with cervix metastasis, and the imaging examination found a strip of solid mass in the right fallopian tube and a nodular mass in cervical canal, which were both hyperintense on T2 weighted image (T2WI) and diffusion weighted image (DWI) and continuous moderate enhancement on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DIAGNOSES: The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as primary malignant mixed mullerian tumors of the fallopian tube with cervix metastasis. INTERVENTIONS: The patient underwent radical hysterctomy, bilateral adnexectomy, pelvic lymph node dissection, omentum majus excision and intravenous chemotherapy. OUTCOMES: Her posttreatment condition was good. LESSONS: Primary malignant mixed mullerian tumors of the fallopian tube can be located by magnetic resonance image examination, which may also offer several diagnostic tips according to changes in signal and enhancement. When combined with pathological findings, qualitative diagnosis can be determined. Surgery and adjuvant chemotherapy are considered as effective methods. Our paper discussed its epidemiology, clinical symptoms, pathologic characters, therapeutic method as well as magnetic resonance imaging findings suggesting the diagnosis and differential diagnosis, including precontrast scan, contrast scan and diffusion weighted image and provided magnetic resonance imaging characteristics of primary malignant mixed mullerian tumors of the fallopian tube described in other literatures.

Rotura uterina espontánea y hemoperitoneo como primera manifestación de tumor mixto mülleriano maligno. Informe de un caso de autopsia y revisión de la literatura / Spontaneous rupture of the uterus and hemoperitoneum secondary to a mixed müllerian tumour. A case report and review of the literature

Se presenta el caso de una mujer de 75 años de edad con malestar general y anemia progresiva de origen desconocido, que falleció por choque hipovolémico. Se realizó estudio de autopsia, donde se encontró rotura uterina y hemoperitoneo, a expensas de una neoplasia uterina maligna. En el estudio histopatológico se evidenció un tumor mixto mülleriano maligno heterólogo. Se realiza una revisión de la literatura acerca de la asociación de esta y otras patologías con ruptura uterina espontánea(AU)

A 75 year old female who died from hypovolemic shock after a period of progressive malaise and anaemia of unknown origin was seen on autopsy to have uterine rupture and haemoperitoneum secondary to a heterologous malignant mixed müllerian tumour. The literature on the association of spontaneous uterine rupture with this neoplasm and other conditions is reviewed(AU)

Intracardiac metastasis of a Malignant Mixed Mullerian tumor (MMMT): progressive dyspnoea due to obstruction of the left atrium and the left ventricle without left ventricular dysfunction or primary lung disease.

Malignant Mixed Mullerian tumors (MMMT) are rare gynecological tumors. Even with surgical treatment, chemotherapy, and/or radiotherapy, outcome is poor. MMMTs are known to metastasize to the liver, the abdomen, and the lungs. One case of an ocular metastasis has been reported. In a 61-year-old female patient who had undergone surgical resection of a Mullerian tumor of the uterus 26 months prior to being admitted to our department, we found an obstructing left atrial mass. Histopathologic assessment of this lesion after surgical resection revealed a Mullerian tumor metastasis. Immediately after surgery, the patient was asymptomatic, but was readmitted 4 months later with dyspnoea. Echocardiography and CT revealed new masses in the left atrium and left ventricle. On a literature review, we did not find any description of left atrial and left ventricular occluding metastases of MMMT.

Mullerianosis vesical: una entidad infrecuente / Mullerianosis of the urinary bladder: a rare entity

OBJETIVO: Descripción de un nuevo caso de mullerianosis vesical.MÉTODO: Presentamos el caso de una paciente mujer de 30 años con antecedentes de aborto, que refiere molestias miccionales coincidiendo con las menstruaciones. Una ecografía vaginal demostró la existencia de lesión exofítica vesical, confirmada posteriormente por cistoscopia. Se indicó resección transuretral.RESULTADOS: En el estudio histopatológico de los tejidos obtenidos se objetivó un componente glandular mixto de tipo predominantemente tubárico, con elementos endometriales y endocervicales asociados. No evidencia de recidiva endoscópica tras un año de seguimiento.CONCLUSIONES: Aportamos un nuevo caso de mullerianosis vesical. Destacamos el escaso número de casos publicados. Defendemos la opción quirúrgica endoscópica en estas pacientes(AU)

OBJECTIVES: To report a new case of bladder mullerianosis.METHOD: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated.RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up.CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its pu-blished reports. We support the option of an endoscopic surgery for these patients(AU)

Malignant mixed mullerian sarcomas of the uterus--the LSUHSC Shreveport experience.

OBJECTIVE: To evaluate our experience with malignant mixed mullerian sarcomas of the uterus (MMMT) and the clinical factors affecting survival. STUDY DESIGN: The records of 18 women with MMMT who received treatment at our hospital between 1989-2002 were reviewed. We analyzed factors influencing survival such as stage, presence of heterologous components, and post-operative radiation. Survival analysis was performed using Kaplan-Meier survival curve. RESULTS: All women underwent surgical tumor debulking. Eleven women were Stage I, three were Stage II, two were Stage III, and two were Stage IV. Five women had tumors with heterologous elements. As expected, survival was most influenced by stage of disease, with the best overall survival in women with Stage I tumors, P < 0.001. Cumulative 5-year survival was 60% for Stage I disease, for Stage II, 34%, and 0% for Stage III and Stage IV. CONCLUSIONS: The initial stage of women presenting with MMMTs is the most important predictive factor for survival.

Midline teratomas, mullerianosis, the multifariousness of gynaecological neoplasias, and the scrotum. Are they manifestations of a germ-soma barrier?

Empirical evidence and theoretical considerations suggest that there are mechanisms protecting the germ line from untoward somatic influences. In the intraorganismal competition between cell lineages, evolution will give priority for protection to the germ line, which carriers the heritable genes. In embryogenesis, germ cells migrate along the midline as this is an area where developmental influences are lower; exposure to somatic factors may cause inception of teratomas. In order not to hinder the germ line, the female genital tract has a reduced level of cell determination, which results in the multifariousness of gynaecological proliferations, including mullerianosis. The external location of testes reduces somatic constraints on spermatogenesis.

Adenosarcoma mulleriano heterólogo en la adolescencia: presentación de un caso clínico y revisión de la literatura / Mullerian, heterologous, adenosarcoma in adolescence: one case presentation and literature review

Se presenta el caso clínico de una paciente de 16 años de edad, con diagnóstico histopatológico de sarcoma mulleriano mixto heterólogo, entidad poco frecuente en la adolescencia. Asimismo se realiza una revisión de sarcomas del útero, su epidemiología, clasificación, perfil clínico, pronóstico y tratamiento