Müllerian adenosarcoma of the uterine cervix with heterologous elements: a light and electron microscopic study

A müllerian adenosarcoma with heterologous elements having the gross appearance of a sarcoma botryoides occurred in the uterine cervix of a 14-year-old girl. Histologically, the tumor was composed of an admixture of benign-appearing glands and a sarcomatous stroma, the latter containing areas of undifferentiated sarcoma and endometrial stromal sarcoma, as well as heterologous elements consisting of rhabdomyosarcoma and hyaline cartilage. No malignant epithelial component was observed. The distribution of benign müllerian-type glands throughout the tumor simulated a malignant mixed müllerian tumor in appearance. Ultrastructural studies of the stromal elements of the neoplasm suggest origin from primitive müllerian stroma, and the glands have features of primitive müllerian epithelium. This study supports the concept that the malignant mixed müllerian tumor and related müllerian sarcomas originate from a common undifferentiated multipotential müllerian stem cell.