title: Vaginal adenosarcoma arising from endometriosis.
abstract: OBJECTIVE
  Malignant transformation of endometriosis has been well documented. Endometrioid adenocarcinoma is the most common malignancy to occur in this setting, although other carcinomas and rarely stromal tumors can be seen. We present the first case in the literature of adenosarcoma, a rare mixed mullerian or mesodermal tumor, arising in extrauterine vaginal endometriosis.
  
  
  METHODS
  A 42-year-old woman underwent multiple medical therapies and surgeries for aggressive endometriosis. A pelvic exenteration was abandoned secondary to severe fibrosis, and low-dose radiotherapy was used to control bleeding from vaginal endometriosis. The pathologic diagnosis of recurrent endometriosis was confirmed multiple times over her 4-year course. Excision of a recurrent vaginal mass revealed adenosarcoma with heterologous elements.
  
  
  CONCLUSIONS
  It is important to biopsy or excise recurrent endometriosis, as malignant transformation can occur, giving rise to epithelial, stromal, or mixed epithelial-mesenchymal tumors.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Minnesota, Minneapolis, Minnesota, 55455, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Judson
authors.forename: A M
authors.initials: AM
authors.lastname: Temple
authors.forename: W C
authors.initials: WC
authors.lastname: Fowler
authors.forename: D B
authors.initials: DB
authors.lastname: Novotny
authors.forename: W K
authors.initials: WK
authors.lastname: Funkhouser
mesh_terms: D018195:Adenosarcoma / Q000473:pathology*; D000328:Adult; D002471:Cell Transformation, Neoplastic; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D012008:Recurrence; D014623:Vaginal Diseases / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000473:pathology*