Primary malignant mixed Müllerian tumor (MMMT) of the ovary is an extremely uncommon neoplasm. These tumors show very aggressive clinical course and high mortality as compared to epithelial ovarian neoplasms. The objective of present study is to present a rare case of primary MMMT homologous type of ovary for its aggressive clinical course and immunohistochemistry findings. A 48-year-old woman presented with complaints of lower abdominal pain, dullness of 3 months duration. USG abdomen pelvis revealed bilateral ovarian solid and cystic mass lesion suggestive of malignant potential. Peritoneal fluid cytology reported as positive for malignant cells. Patient underwent exploratory laparotomy which showed large bilateral ovarian masses with extensive nodular deposits all over pelvic-abdominal organs. Optimal debulking surgery was performed and specimen examined for histopathology. On histopathology, it was reported as bilateral ovarian MMMT homologous type. Immunohistochemistry was done which showed the tumor cell expression positive for CK, EMA, CK7, CA-125, and WT1. Also a distinct population tumor cells express Cyclin D1 and focal and patchy expression of CD-10. Tumor was negative for Desmin, PLAP, Calretin, and inhibin. The patient received operative, chemotherapy and adjuvant therapy along with extensive electrolyte, nutritive, and supplementary support. The patient, however, rapidly deteriorated and died within 9 months of postoperative day. Primary ovarian MMMT is an extremely uncommon neoplasm, and it showed extensive aggressive clinical course and even with operative, chemotherapy, and adjuvant therapy, the patient yields poor prognosis.
Keywords: adjuvant therapy; chemotherapy in ovarian cancer; malignant mixed Müllerian; primary ovarian tumor.
Primary ovarian malignant mixed Müllerian tumor: a rare case report Ovarian carcinomas: These are the most common type of ovarian cancer. About two-thirds of these cancers are of epithelial origin. Obesity, hormone replacement therapy, not having children, and family history of ovarian cancer are risk factors for ovarian cancer. A neoplasm is a type of abnormal and excessive growth of tissue. Neoplasms arising from more than one cell type or germ layer are called ‘mixed tumors’. Ovarian carcinosarcoma, also known as a malignant mixed Müllerian tumor (MMMT) of the ovary, is a rare, aggressive cancer of the ovary with characteristics of two types of cancer: carcinoma and sarcoma. In this case, we reported a very uncommon and rapidly progressive tumor with a high chance of death even with an advance treatment protocol. Because women with this cancer often have no symptoms, more than half of women are diagnosed at an advanced stage. These cancer cells spread first from surface of the ovary to the lining and organs of the pelvis and abdomen and then to other parts of the body. Diagnosis of ovarian cancer starts with a physical examination, a blood test (for CA-125 and sometimes other markers), transvaginal ultrasound, CT scanning, and so on. The diagnosis must be confirmed with surgery to inspect the abdominal cavity and take biopsies for microscopic analysis. Required advanced ovarian cancer treatment depend on various factors, such as surgery, chemotherapy, radiation, hormonal therapy, and palliative care as per required. Message: Primary ovarian MMMT is an extremely uncommon neoplasm, and in this case we showed a patient with an extensive aggressive clinical course, and even with surgery, chemotherapy, and adjuvant therapy, it showed poor prognosis.
© The Author(s), 2022.