title: Clinicopathological spectrum of 19 adenosarcomas of female genital tract, including uncommon clinical associations and immunohistochemical profile, reviewed at a single institution.
abstract: BACKGROUND
  Adenosarcomas of the female genital tract have been rarely documented as case series from our continent.
  
  
  METHODS
  Over a seven-year period, 19 adenosarcomas were critically reviewed.
  
  
  RESULTS
  Nineteen tumors occurred in the age range of 21-65 years (mean: 43), in the endometrium (8), endometrium and cervix (4), cervix (4), and ovary (3). Four cases displayed coexisting leiomyomas; two, adenomyosis; two on background endometriosis; and one in post-treated cervix carcinoma. Histopathologically, the tumors were low grade (10; 52.6%) and high grade (9; 47.3%), the latter with sarcomatous overgrowth (SO) (7/9 cases). Dedifferentiation (8, 42.1%) and conspicuous decidualization (2) were noted. Immunohistochemically, the tumors focally expressed CD10 (4/6), smooth muscle actin (SMA) (3/8), desmin (8/11); diffuse vimentin (7/7), and estrogen receptor/progesterone receptor (ER/PR) (2/4). Ki-67 (6 cases) varied 5-20%. Seventeen patients underwent surgery and four received adjuvant treatment (3/4 high-grade tumors). Five tumors recurred (4 high-grade tumors with SO) and one metastasized. Among 11 patients, five were alive with disease (AWD) (mean: 29.4 months) and six, free of disease (FOD) (mean: 15 months), the latter mostly with low-grade type tumors (83.3% cases).
  
  
  CONCLUSIONS
  Diverse clinicopathological spectrum was noted within adenosarcomas. Low-grade tumors were less aggressive than high-grade ones, with SO. Immunohistochemically, lower CD10 and ER/PR positivity was noted in high-grade tumors. Surgery formed the mainstay of treatment. Adjuvant treatment was offered in high-grade subtypes, including in tumors with SO.
authors.affiliation: Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Bharat
authors.initials: B
authors.lastname: Rekhi
authors.forename: Kedar K
authors.initials: KK
authors.lastname: Deodhar
authors.forename: Amita
authors.initials: A
authors.lastname: Maheshwari
authors.forename: Santosh
authors.initials: S
authors.lastname: Menon
authors.forename: Rajendra
authors.initials: R
authors.lastname: Kerkar
authors.forename: Jyoti
authors.initials: J
authors.lastname: Bajpai
authors.forename: Jaya
authors.initials: J
authors.lastname: Ghosh
authors.forename: Sudeep
authors.initials: S
authors.lastname: Gupta
authors.forename: Reena
authors.initials: R
authors.lastname: Engineer
authors.forename: Shyam K
authors.initials: SK
authors.lastname: Shrivastava
mesh_terms: D018195:Adenosarcoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis*; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D008853:Microscopy; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm