TUBANIN MALİGN MİKST MÜLLERİAN TÜMÖRÜ: MORFOLOJİK AÇIDAN FARKLI İKİ OLGU

Abstract

Amaç: Malign mikst müllerian tümörler (MMMT) epitelyal ve mezenkimal komponentler içeren çok agresif bifazik neoplazmlardır. Kadın genital sisteminde tubada MMMT’ler nadiren görülürler. Olgu Sunumu: Bu bildiride tuba fimbrial uç yerleşimli iki MMMT olgusu sunulmaktadır. Her iki hastada FIGO evresi IIIC (T3c N0 M0) idi. Tümörlerden biri homolog, diğeri heterolog tipteydi. Tartışma: Bu nadir tümörlerin prognozu kötüdür. Hastalarımızdan biri tanı konduktan 6 ay sonra yaşamını yitirmiştir. Bu tümörler için sağkalımı artırmada tam cerrahi, kemoterapi ve eksternal radyoterapi zorunlu görünmektedir.

Keywords

• Karsinosarkom, malign mikst müllerian tumor, tuba.

MALIGNANT MIXED MÜLLERIAN TUMOR OF THE FALLOPIAN TUBE: MORPHOLOGICALLY DIFFERENT TWO CASES

Abstract

Objective: Malignant mixed müllerian tumors (MMMT) are highly aggressive biphasic neoplasms consisting of both epithelial and mesenchymal components. In female genital tract, MMMTs are rarely seen in fallopian tube. Case Report: We will present two cases of MMMT of fallopian tube located at the fimbrial end. Both patients were FIGO stage IIIC (T3c N0 M0). One of the tumor was homologous and the other one heterologous variety. Conclusion: These rare tumors have poor prognosis, as one of the patients died only in 6 months after the diagnosis. For these tumors complete surgery, chemotherapy and external radiation seemed to be necessary in order to improve survival.

Keywords

• Carcinosarcoma, malignant mixed müllerian tumor, Fallopian tube

References

1. 1. Gupta R, Jenison EL. A rare case of carcinosarcoma of the fallopian tube presenting with torsion, rupture and hemoperitoneum. Gynecol Oncol Case Rep. 2011;2:4-5.
2. 2. Arioz DT, Yilmaz S, Okur N, Aktepe F, Yilmazer M, Ozalp S. Primary malignant mixed müllerian tumor of the fi mbriated end of the fallopian tube causing hematosalpinx and hematometra. N Am J Med Sci. 2012;4:659-61.
3. 3. Hellström AC, Auer G, Silfversward C, Pettersson F. Prognostic factors in malignant mixed müllerian tumor of the fallopian tube. Int J Gynecol Cancer 1996; 6:467-72.
4. 4. Costa MJ, Guinee D Jr. CD34 Immunohistochemistry in Female Genital Tract Carcinosarcoma (Malignant Mixed Müllerian Tumors) Supports a Dominant Role of the Carcinomatous Component. Appl Immunohistochem Mol Morphol 2000;8:293–9.
5. 5. Amr SS, Tavassoli FA, Hassan AA, Issa AA, Madanat FF. Mixed mesodermal tumor of the uterus in a 4-year-old girl. Int J Gynecol Pathol 1986;5:371-8.
6. 6. Alvarado-Cabrero I, Cheung A, Caduff R. Tumors of the fallopian tube. In: Tavassoli FA, Devilee P (Ed.s). Pathology and Genetics of Tumours of the Breast and Female Genital Organs. IARC Press, Lyon, 2003; pp. 206-11.
7. 7. McCluggage WG. Malignant biphasic uterine tumours: carcinosarcomas or metaplastic carcinomas? J Clin Pathol 2002;55:321–325.
8. 8. Choijamts B, Jimi S, Kondo T, et al. CD133+ Cancer Stem Cell–like Cells Derived from Uterine Carcinosarcoma (Malignant Mixed Müllerian Tumor). Stem Cells 2011;29:1485– 95.

9. 9. Norris HJ, Taylor HB. Mesenchymal tumors of the uterus 3. A clinical and pathologic study of 31 carcinosarcomas. Cancer. 1966;19:1459-65.
10. 10. Silverberg SG, Major FJ, Blessing JA, et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 1990;9:1-19.
11. 11. Ozguroglu M, Bilici A, Ilvan S ve ark. Determining predominating histologic component in malignant mixed müllerian tumors: is it worth it? Int J Gynecol Cancer 2008;18:809– 12.
12. 12. Kurshumliu F, Rung-Hansen H, Skovlund VR, Gashi- Luci L, Horn T. Primary Malignant Mixed Mullerian Tumor of the Peritoneum: A Case Report with review of the literature. World J Surg Oncol 2011;9:17.
13. 13. Alvarado-Cabrero I, Navani SS, Young RH, Scully RE. Tumors of the fi mbriated end of the fallopian tube: a clinicopathologic analysis of 20 cases, including nine carcinomas. Int J Gynecol Pathol. 1997;16:189-96.
14. 14. Gagner JP, Mittal K. Malignant mixed Müllerian tumor of the fi mbriated end of the fallopian tube: origin as an intraepithelial carcinoma. Gynecol Oncol 2005;97:219–22.
15. 15. Carlson JA Jr, Ackerman BL, Wheeler JE. Malignant mixed müllerian tumor of the fallopian tube. Cancer 1993;71:187- 92.
16. 16. Duska LR, Garrett A, Eltabbakh GH, Oliva E, Penson R, Fuller AF. Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary. Gynecol Oncol 2002;85:459-63.
17. 17. Kawaguchi W, Itamochi H, Kigawa J, et al. Chemotherapy consisting of paclitaxel and carboplatin benefi ts a patient with malignant mixed müllerian tumor