title: Müllerian adenosarcoma of vagina arising in persistent endometriosis: report of a case and review of the literature.
abstract: BACKGROUND
  Primary adenosarcoma arising in vaginal endometriosis poses a diagnostic challenge, especially in superficial vaginal biopsies.
  
  
  METHODS
  A 56-year-old woman, with a prior diagnosis of ovarian endometriosis, presented with a rapidly enlarging mass of the vaginal vault. Two prior biopsies were benign and showed endometriosis. The third vaginal biopsy revealed benign endometriotic glands cuffed by a cellular stroma with moderate cytologic atypia, a histological appearance diagnostic of Müllerian adenosarcoma. A 16-cm vaginal mass that had infiltrated the pelvic structures was resected.
  
  
  CONCLUSIONS
  Close clinical follow-up of extrauterine endometriosis and clinical-pathologic correlation is necessary. Histological features such as cellular stromal cuffing around benign endometriotic glands are critical in arriving at a timely diagnosis of adenosarcoma in patients with persistent extrauterine endometriosis, even in superficial vaginal biopsies.
authors.affiliation: Department of Pathology, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
authors.forename: Lanting
authors.initials: L
authors.lastname: Liu
authors.forename: Susan
authors.initials: S
authors.lastname: Davidson
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Singh
mesh_terms: D018195:Adenosarcoma / Q000209:etiology* / Q000473:pathology; D004715:Endometriosis / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000209:etiology* / Q000473:pathology; D014625:Vaginal Neoplasms / Q000209:etiology* / Q000473:pathology