Title: Malignant mixed Mullerian tumour (MMMT) of uterus: Rare and aggressive Tumor
Authors: Dr Anbu Chandrasekaran, Dr Ashutosh Kumar, Dr Tarun Kumar, Dr Ashok Chauhan, Dr Paramjit Kaur, Dr Anil Khurana
A malignant mixed Mullerian tumour (MMMT), also known as uterine carcinosarcoma (UC). MMMT is an extremely rare and very aggressive tumour, comprising only 1–2% of uterine neoplasms1. In the United States, the annual incidence of uterine sarcomas is about 2 per 100,000 women; more than 50% of these are MMMTs. MMMT have a poorer prognosis than those with uterine carcinoma. Five-year survival rates of patients with MMMT that range between 33% and 39%.2 Most of women are post-menopause, especially between the 6th and the 7th decade.3 Risk factors of MMMT are nulliparity, obesity, advanced age, exposure to exogenous oestrogens, pelvic irradiation, and long-term use of tamoxifen.4,5,6 MMMT is responsible for 15% of deaths from uterine malignancy.7 More than 50% of MMMT patients present with advanced-stage disease.8. MMMT recently classified as high-grade endometrial carcinoma.9,10 MMMT are characterized by both a carcinomatous (eg, endometriod, serous, and clear cell) and a sarcomatous component, and the sarcoma can contain either homologous (eg, fibrosarcoma, leiomyosarcoma) or heterologous, nonnative (eg, rhabdomyosarcoma and osteosarcoma) elements. Prognostic factors of MMMT are surgical stage, lymphovascular space invasion (LVSI), depth of myometrial invasion, tumor histology, and patient age.11Since MMMTs are extremely rare and there is a paucity of data, we conducted the present study to analyse the outcome of this type of tumour. Here we report two cases of malignant mixed Mullerian tumor of the uterus with homologous elements.