Müllerian adenosarcoma mimicking cervical carcinoma in a 79-year-old woman: diagnostic challenges and laparoscopic treatment: a case report

TL;DR

A 79-year-old woman's cervical-like tumor was actually a rare uterine adenosarcoma, highlighting the importance of accurate diagnosis and surgical treatment.

Contribution

This is the first detailed case report of Müllerian adenosarcoma presenting as a cervical cancer-like mass in an elderly woman.

Findings

The tumor was initially misdiagnosed as advanced cervical carcinoma due to its appearance on imaging.

Complete surgical excision led to a disease-free status at 7 months, confirming good outcomes for stage I adenosarcoma.

WT1/ER immunohistochemistry was critical in determining the tumor's origin and guiding treatment.

Abstract

Uterine Müllerian adenosarcoma rarely presents as a cervical “cancer-like” mass; we report the first detailed case in a 79-year-old woman whose 5-cm exophytic lesion mimicked advanced cervical carcinoma on imaging. She presented with 2 weeks of post-menopausal bleeding and a friable polyp protruding through the cervical os; MRI described a bulky cervical tumour extending into the lower uterine segment, while tumour markers remained normal. Initial biopsy was inconclusive; subsequent excision and hysterectomy revealed FIGO stage Ib1 low-grade adenosarcoma originating from the lower uterine segment with superficial cervical involvement. Laparoscopic total hysterectomy with bilateral salpingo-oophorectomy was performed uneventfully, and at 7 months she remains disease-free. The case underlines that adenosarcoma can masquerade as cervical cancer, emphasises the need for generous tissue sampling and WT1/ER-based immunohistochemistry to define tumour origin, and confirms excellent outcomes with complete surgical excision for stage I disease.

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