Mullerian Adenosarcoma of Uterus Following Tamoxifen Use- A Case Report

Abstract

Mullerian adenosarcoma is a rare tumor. Around 200 cases have been reported till date. This tumor usually occurs in peri or postmenopausal women and asymptomatic presentation is rarely reported. Use of tamoxifen has been considered to be a risk factor for this tumor occurrence. We here report a woman who was referred due to detection of a suspected malignant mass on PET scan, which was done to follow up the patient after treatment of breast cancer. Patient had history of tamoxifen use for 5years. But she was asymptomatic. Total abdominal hysterectomy with bilateral salphingo-oophoectomy was done. Histological examination confirmed the diagnosis of mullerian adenosarcoma. Post-operative course was uneventful and radiotherapy was given later in a nuclear medicine centre. This article wishes to emphasize the importance of recognizing this tumor for both gynecologists and pathologists. Uterine adenosarcoma has variable survival rate depending on its sarcomatous component, lympho-invasion, and myoinvasion. This patient showed no lymph invasion and no myoinvasion, which account for her good prognosis. Oncologists and gynecologists should be aware that this tumor can occur in patients with history of tamoxifen use, as a positive correlation has been seen in reported cases.