Heterologous Malignant Mixed Mullerian Tumor in a Diabetic Patient

Abstract

• Uterine malignant mixed müllerian tumor (MMMT) is an uncommon carcinosarcomatous neoplasm with a highly malignant, biphasic pattern consisting of both epithelial and mesenchymal components. This paper reports the clinical, pathological and immunohistochemical features of heterologous MMMT of a diabetic and hypertensive patient. A 73-year-old white woman presented with post- menopausal bleeding for six months. The patient underwent TAH&BSO with pelvic lymph nodes dissection. In pathologic evaluations, a polypoid solid and white mass measuring 4.5cm×3cm×1.5cm was identified. Light microscopy showed biphasic pattern of epithelial component with clear cell change and sarcomatous elements of spindle cells with cartilage and bone differentiation. Immunohistochemistry was performed on formalin fixed and paraffin embedded tissue with a panel of immunohistochemical markers comprising cytokeratin (CK), vimentin and S100. The epithelial component was reactive for CK and vimentin. S100 positivity was seen in stromal and chondroid elements; so the diagnosis of MMMTS was confirmed. CONCLUSION: There may be an association between diabetes mellitus and the development of malignant mixed mesodermal tumor. Special attention should be paid when attempting to sample the endometrium of these patients. But further studies are needed to verify this hypothesis.
• KEYWORDS: Post- menopausal bleeding, Heterologous Malignant Mixed Mullerian Tumor, Diabetes mellitus, Hypertension.