What is the diagnosis?

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What is the diagnosis?

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6 Posts

jean robert
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05/17/08 - 12:25 AM

#1

A 75 yr old female presents to the doctor with a chief complaint of vaginal spotting.She has been post-menopausal for 25 years and doesn t take hormones. An ultrasound is performed, and shows a mass in the uterine fundus. A hysterectomy is performed, and pathologic examination of the removed uterus reveals a malignant tumor of the endometrial glands and stroma.Which of the following is the most likely diagnosis?

a) Endolymphatic stromal myosis

b) Endometrial carcinoma

c) Endometrial stromal sarcoma

d) Leiomyosarcoma

e) Malignant mixed mullerian tumor.

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match2010
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05/17/08 - 01:12 AM

#2

B..endometrial carcinoma .....bleeding in postmenopausal women is endometrial carcinoma unless proven otherwise .

Edited by Aashi on 05/17/08 - 11:12 AM

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1.ammara
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05/17/08 - 10:21 AM

#3

I'll go for E as it states both malignant glands and stroma!

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Aashi
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05/17/08 - 11:12 AM

#4

match2010 wrote:
B..endometrial carcinoma .....bleeding in postmenopausal women is endometrial carcinoma unless proven otherwise .

You are right abt Endo CA..But Endo ca contain ONLY epithelial glandular element..The Malignant tumor described in the q contains both stromal and glandular component and hence E( malignant Mixed Mullerian Tumor )shld be the answer here

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jean robert
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05/18/08 - 12:42 AM

#5

Correct Answer: E

EXPLANATION

Malignant mixed mullerian tumor is a tumor with 2 components, STROMAL and EPITHELIAL (endometrial glands), both of which are malignant. This is a rare and highly aggressive tumor that has a 25% 5 year survival rate. It usually affects Older patients and presents with Postmenopausal bleeding. The stromal component can contain metaplastic components such as cartilage and bone. Interestingly,usually only the epithelial component metastasizes.

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jean robert
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05/18/08 - 12:46 AM

#6

Endometrial carcinoma (choice B) is a malignancy of the epithelial glandular component of the endometrium. Abnormal bleeding is the usual presentation.High estrogen state cause this tissue to proliferate. There s NO STROMAL component of this tumor.

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