An evolution of malignant mixed müllerian tumor

In an unusual example of malignant mixed müllerian tumor, a tumor originated in the uterine corpus as an endometrial carcinoma consisting of ordinary endometrial adenocarcinoma, papillary adenocarcinoma, mucinous adenocarcinoma, and squamous cell carcinoma. Following hysterectomy, the tumor recurred at the vaginal vault as poorly differentiated papillary adenocarcinoma. During the second recurrence as a pelvic tumor about 3 years after hysterectomy, the tumor evolved into a malignant mixed müllerian tumor with predominance of sarcomatous element. The latter included undifferentiated sarcoma, endometrial stromal sarcoma, fibromyxosarcoma, leiomyosarcoma and rhabdomyosarcoma. These findings support the contention of Sternberg et al. that a malignant mixed müllerian tumor may exceptionally originate in an endometrial carcinoma.