title: Malignant mixed mullerian tumor of the ovary: report of four cases.
abstract: BACKGROUND
  Malignant mixed mullerian tumor (MMMT) of the ovary is an extremely rare gynaecologic neoplasm that represents 1% of the malignances of this organ. Stage I disease is rare because it is asymptomatic in early stage. We describe four cases.
  
  
  METHODS
  In the Department of Obstetrics and Gynecology of the University of Bari four cases of MMMT of the ovary were diagnosed. Three patients were in stage IIIC and one of them was a homologous MMMT; the fourth patient was affected by a heterologous stage IV MMMT. All women were treated with surgery and chemotherapy. Two patients are alive 14 and 12 months after diagnosis. The other two died after 37 months and one month, respectively.
  
  
  CONCLUSIONS
  The malignant mixed mullerian tumor (MMMT) of the ovary is a particularly aggressive tumor, especially in advanced stages. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment for this neoplasm is unknown because of its rarity. Our experience, when considering survival, seems to confirm the use of cisplatin and ifosfamide and to give new horizons to taxol.
authors.affiliation: Gynecology Oncology Unit, University of Bari, Italy.
authors.forename: G A
authors.initials: GA
authors.lastname: Melilli
authors.forename: L
authors.initials: L
authors.lastname: Nappi
authors.forename: C
authors.initials: C
authors.lastname: Carriero
authors.forename: M
authors.initials: M
authors.lastname: Lapresa
authors.forename: V
authors.initials: V
authors.lastname: Loizzi
authors.forename: F
authors.initials: F
authors.lastname: Caradonna
authors.forename: M
authors.initials: M
authors.lastname: Quaranta
authors.forename: G
authors.initials: G
authors.lastname: Putignano
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D011379:Prognosis