title: Diagnosis and management of Müllerian adenosarcoma of the uterine cervix.
abstract: OBJECTIVE
  To report on the diagnosis and management of Müllerian adenosarcoma of the uterine cervix at a gynecologic oncology unit in Singapore.
  
  
  METHODS
  Nine cases (1992-2008) were identified from the unit registry. All hospital records were retrospectively analyzed.
  
  
  RESULTS
  Mean age at diagnosis was 45±12 years (range, 17-61 years). Presenting symptoms were abnormal vaginal bleeding (5 [55.6%] patients), introital mass (3 [33.3%] patients), and foul-smelling vaginal discharge (1 [11.1%] patient). Two (22.2%) patients were asymptomatic, with cervical polyps discovered incidentally on routine gynecologic check-up. All women had benign-looking cervical polyps and underwent polypectomy. Histology showed increased stromal cellularity with periglandular cuffs in all patients, and heterologous differentiation in 1(11.1%) patient. All 9 women had FIGO stage 1B disease. Seven (77.8%) patients underwent radical hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy. One (11.1%) woman underwent cervical wedge resection and 1 (11.1%) refused definitive surgery. There was no recurrence in the 6 patients for whom complete follow-up data were available.
  
  
  CONCLUSIONS
  Clinical diagnosis of Müllerian adenosarcoma of the uterine cervix may be challenging owing to the benign gross appearance of the cervical polyps. Surgery provides a good chance of cure with no recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Kandang Kerbau Women's and Children's Hospital, Singapore. peishi@starhub.net.sg
authors.forename: Pui-See
authors.initials: PS
authors.lastname: Chin
authors.forename: Yin-Nin
authors.initials: YN
authors.lastname: Chia
authors.forename: Yong-Kuei
authors.initials: YK
authors.lastname: Lim
authors.forename: Kwai-Lam
authors.initials: KL
authors.lastname: Yam
mesh_terms: D018195:Adenosarcoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D033162:Incidental Findings; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012846:Singapore; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D055815:Young Adult