Malignant mixed Mullerian tumor of the ovary

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nicht verwechseln mit: Malignant mixed germ cell tumor of the ovary

Malignant mixed Mullerian tumors (MMMT) of the ovary, also known as carcinosarcoma of the ovary, are a rare type of mixed ovarian tumor with both epithelial and stromal components.

Epidemiology

They are very rare and account for less than 1% of all ovarian cancers. Most women are post-menopausal at the time of presentation and usually between their 6 to 8 decades of life.

Clinical presentation

Patients often present with an abdominal mass, ascites, and anemia. As with other ovarian tumors, the presentation can be vague.

Pathology

MMMTs are histologically biphasic tumors with both carcinomatous (epithelial) and sarcomatous (stromal) elements.

Radiographic features

On imaging, it is not possible to differentiate carcinosarcomas from other ovarian neoplasms, and therefore the diagnosis is essentially based on histopathologic findings. Features common to ovarian neoplasms, in general, may be present.

A high incidence of hemorrhagic ascites has been reported in those with advanced disease reported is >50% of the patients having ascites from the tumors.

Treatment and prognosis

They are malignant aggressive neoplasms carrying a poor prognosis even despite a combination of surgical debulking, radiation therapy, and chemotherapy. Metastasis generally involves serosal and peritoneal seeding. Median survival rates reported in the literature range ~7-10 months at the time of initial writing .

Staging

The FIGO system is commonly used for staging: see ovarian cancer staging.