Abstract
Background
Müllerian adenosarcoma is a biphasic neoplasm most commonly occurring in the uterus
and less frequently of the ovary. It has been rarely described to occur in other sites
such as peritoneum and liver.
Patients and Methods
In this study, we report the clinicopathologic, immunohistochemical and molecular
features of a primary Müllerian adenosarcoma of the urinary bladder in a 62-year-old
woman. To our knowledge, this is the first report of detailed pathologic characterization
of Müllerian adenosarcoma primary to the urinary bladder in the literature.
Results
Light microscopy showed a biphasic epithelial and stromal tumor with benign-appearing
glands surrounded by densely cellular endometrial-type stroma that is densely cellular
with increased mitotic figures. The stroma surrounding the glands was more cellular
than the intervening areas, which were more loose and edematous. Immunohistochemistry
staining revealed positive staining for Pax-2/8 within the glands, for positive CD10
and WT-1 within the spindle cell stroma, and for estrogen and progesterone receptors
in both. Staining for desmin, GATA3, p63, and human papillomavirus was negative. Molecular
analyses identified mutations in protein kinase B E17K, fms related tyrosine kinase
3 D835N, KRAS proto-oncogene, GTPase G12D, and HRAS proto-oncogene, GTPase G12S. These
novel molecular aberrations have yet to be reported in the medical literature. X chromosome
inactivation analysis revealed a clonal pattern in the stromal component and a nonclonal
pattern in the epithelial component. Currently, the patient is disease/recurrence-free
after regular follow-up of approximately 84 months.
Conclusion
This case represents, to our knowledge, the first reported diagnosis of Müllerian
adenosarcoma arising in the urinary bladder with extensive clinicopathologic, immunohistochemical,
and molecular analyses.
Keywords
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Article info
Publication history
Published online: May 24, 2017
Accepted:
May 16,
2017
Received:
May 7,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
