Malignant Mixed Mullerian Tumour of Uterus

Dr Vani Malhotra, Malhotra P, Nanda S, Chauhan M, Bhuria V, Mittal A

Dr Vani Malhotra, Malhotra P, Nanda S, Chauhan M, Bhuria V, Mittal A

Keywords: polyp, abnormal uterine bleeding

Abstract

Background: Malignant mixed Mullerian tumors (MMMTs) are metaplastic carcinomas including both carcinomatous and sarcomatous elements. Case: A 65-year-old postmenopausal female presented to outpatient department with chief complaints of blood mixed vaginal discharge for the last 10 days. Speculum examination revealed a large, necrotic, foul smelling polyp of approximately 4 x 4 centimeters size seen coming out through the external os. Vaginal examination revealed that the cervix was dilated and taken up and the same polypoid mass was felt coming out through the os. Polypectomy along with endometrial biopsy was done and tissue was sent for histopathological examination which revealed features of malignant mixed mullerian tumor in the polyp and the endometrial biopsy showed necrotic tissue. Result: Patient underwent total abdominal hysterectomy along with bilateral salpingoopherectomy and pelvic lymphnode sampling.
On cut section of the uterine corpus, a polypoid growth of size 3 x 2 centimeters was identified which on histopathology confirmed the diagnosis of a homologous uterine malignant mixed mullerian tumor involving more than half the thickness of myometrium. Conclusion: With a highly aggressive nature and limited therapeutic options, MMMTs represent one of the most lethal neoplasms of the female genitourinary tract.

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