Adenosarcoma

 

Epidemiology:

    • Middle-aged or elderly women usually

 

Common sites:

    • uterus

 

Gross features:

    • Polypoid endometrial tumour

 

Histologic features:

    • Appearance similar to a malignant cystosarcoma of the breast (phyllodes)
    • Benign-appearing glandular component
      • Compressed
      • Slit-like
      • Polypoid, leaf-like
    • Stromal component:
      • Hypercellular
      • Mild to moderate nuclear atypia
      • Occasional but not numerous mitotic figures
      • periglandular cuffing or concentration of stromal cells is an important clue
      • presence of the following features usually indicate a potential for metastasis
        • marked pleomorphism
        • necrosis
        • mitotic activity
      • presence of the following are particularly ominous
        • sarcomatous overgrowth (>25% of lesion)
        • rhabdomyoblastic differentiation
    • mets are stromal component only

 

Immunophenotype:

Marker:

Sensitivity:

Specificity:

 

 

 

 

Molecular features:

    •  

 

Other features:

    • Local recurrence in 30%
    • Distant metastases in 10%

 

References:

    • Silverberg SG, DeLellis RA, Frable WJ, LiVolsi VA, Wick MR. Silverberg's Principles and Practice of Surgical Pathology and Cytopathology: 2-Volume Set. 4th ed. Churchill Livingstone; 2005.