MALIGNANT MIXED MULLERIAN TUMOUR OF UTERUS - A CASE REPORT

Malignant mixed mullerian tumour is a relatively rare , biphasic , highly aggressive malignant neoplasms that occur in any of the female reproductive organs that contains both epithelial and connective tissue components , most commonly seen in the uterine corpus ,rarely in cervix , fallopian tube, ovary, peritoneum etc .These tumours originates from the mesothelium and mesenchyme of embryonic mesoderm . Uterine malignant mixed mullerian tumour accounts for 3 to 5 percent of uterine malignancies ,most commonly occurs in postmenopausal women and risk factors similar to that of endometrial carcinoma with high recurrence and metastases and poor prognosis . The clinical picture and diverse spectrum of histopathological pattern of the malignant mixed mullerian tumours had led to subject of interest .The interesting aspect of the origin of these biphasic malignant tumour , with a case report of 68 years postmenopausal women , known diabetic and hypertensive , presented with postmenopausal bleeding and pelvic examination revealed uterus enlarged to 10 to 12 weeks with no adnexal pathology .Endometrial biopsy - moderately differentiated endometrial adenocarcinoma ,grade II and proceeded with staging laparotomy with pelvic lymph node dissection .Gross specimen showed soft , friable growth filling the entire endometrial cavity. Histopathology report proved in to be a malignant mixed mullerian tumour or carcinosarcoma uterus ,stage I . Myometrial invasion of less than 50 percent ,Tumour size of less than 7 cms ,No detectable invasion or metastases were the favourable prognostic features with the above case .Recovery was uneventful . Patient remains asymptomatic and is on regular follw up .