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Case Report
Generalized metastases of uterine adenosarcoma with sarcomatous overgrowth: A case report
1 PhD, Programa en Ciencias Genómicas, Universidad Autónoma de la Ciudad de México (UACM), Apdo, Postal 03100, Ciudad de México, Mexico
2 PhD, Unidad de Investigación Biomédica en Cáncer del Instituto Nacional de Cancerología, Ciudad de México, Mexico
3 PhD, Patología, UMAE Pediatría, CMNSXXI, IMSS, Mexico
4 PhD, Departamento de Piel y Partes Blandes del Instituto Nacional de Cancerología, Ciudad de México, Mexico
Address correspondence to:
Angeles C Tecalco-Cruz
PhD, Programa de Ciencias Genómicas, Universidad Autónoma de la Ciudad de México (UACM), Apdo, Postal 03100, Ciudad de México,
Mexico
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Article ID: 100070Z08AC2021
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Tecalco-Cruz AC, Cortés-González CC, Rodríguez-Florido MA, García-Ortega DY. Generalized metastases of uterine adenosarcoma with sarcomatous overgrowth: A case report. J Case Rep Images Obstet Gynecol 2021;7:100070Z08AC2021.ABSTRACT
Introduction: Uterine adenosarcoma with sarcomatous overgrowth (ASO) is a rare sarcoma associated with a high risk of poor patient outcomes. There may be an increased risk of recurrence with ASO and local invasion; however, distant metastasis is not reported often.
Case Report: We present a case of generalized metastases of ASO in a 68-year-old patient. She presented abnormal vaginal bleeding and progressive, intense pelvic and abdominal pain. Different biopsies were performed and described as a neoplasm compatible with a tumor of endometrium stroma and hyperplasia. She underwent a hysterectomy (PIVER type III) with intraoperative analysis, and the diagnosis of ASO with lymphovascular invasion was made. Vaginal bleeding recurred two months post-hysterectomy, and a polyp in the vaginal dome was detected. Computed tomography (CT) revealed bladder, liver, and lung metastases. The patient developed difficulty in breathing, necessitating supplemental oxygen. She required urinary catheterization and suffered from frequent constipation. She also received antibiotics and analgesics as palliative treatment at home. Two months and sixteen days posthysterectomy, before chemotherapy was initiated, she died while sleeping.
Conclusion: ASO tumors are highly aggressive. Rapid-action protocols to avoid delays in the diagnosis and treatment are required. In this context, the difficulty of interpreting biopsies may be indicating this disease, and CT may help in the diagnosis. Early hysterectomy with adjuvant therapy may improve the prognostic of ASO patients. Abnormal vaginal bleeding is a critical symptom in postmenopausal women, and aging is also a risk factor for ASO.
Keywords: A case report, Generalized metastases, Sarcomatous overgrowth, Uterine adenosarcoma
SUPPORTING INFORMATION
Acknowledgments
We thank M.Sc. Noé Santiago Alavez Pérez and Dr. Josué O. Ramírez-Jarquin for their comments about this manuscript. We thank the support from CONACYT and SECTEI (grant numbers: FOSSIS A3-S-54604 and SECTEI/276/2019 to C.C.C.-G.).
Author ContributionsAngeles C Tecalco-Cruz - Substantial contributions to conception and design, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Carlo C Cortés-González - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Marco A Rodríguez-Florido - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Dorian Y García-Ortega - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient’s family for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Angeles C Tecalco-Cruz et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
