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1. Sharma NK, Sorosky JI, Bender D, Fletcher MS, Sood AK: Malignant mixed mullerian tumor (MMMT) of the cervix. Gynecol Oncol; 2005 May;97(2):442-5
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  • [Title] Malignant mixed mullerian tumor (MMMT) of the cervix.
  • OBJECTIVES: To characterize the clinical characteristics, therapeutic options, and potential outcomes in patients diagnosed with malignant mixed mullerian tumor (MMMT) of the uterine cervix.
  • METHODS: Five women ranging in age from 25 to 66 (mean 49.6 years) were diagnosed with MMMT of the cervix and treated at the University of Iowa Hospitals and Clinics between 1986 and 2001.
  • Data were retrospectively analyzed from available charts and pathological reports with particular attention to patient demographics, presenting symptoms, treatment, and follow-up.
  • FIGO disease staging at initial diagnosis included two patients with stage IB1 (ages 29 and 66 years), two patients with stage IB2 (ages 25 and 64 years), and one patient with stage IVB (age 64 years) MMMT of the cervix.
  • Organ-confined, early stage lesions (stages IB1 and IB2) responded well to regimens of either surgery alone or surgery plus radiation therapy, with no evidence of recurrent disease at last follow-up 28, 35, 42, and 65 months later, respectively.
  • The lone patient with advanced stage IVB disease, however, was unresponsive to both external beam radiation therapy and ifosfamide chemotherapy, and succumbed to disease within 5 months.
  • CONCLUSIONS: Cervical MMMT is an uncommon disease, but long-term survival is possible in organ-confined early stage disease with primary therapy.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Mixed Tumor, Mullerian / therapy. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Treatment Outcome


2. Chao KC, Wang PH, Chang CC, Lai CR, Ng HT: Establishment and characterization of a cell line, MT-213-VGH, isolated from a mixed müllerian tumor of the uterus. Acta Cytol; 2001 Sep-Oct;45(5):683-90
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  • [Title] Establishment and characterization of a cell line, MT-213-VGH, isolated from a mixed müllerian tumor of the uterus.
  • OBJECTIVE: To establish a cell line from a woman with malignant mixed müllerian tumor of the uterus and to examine the biologic properties of this cell line (MT-213-VGH).
  • Histologic staining of mixed müllerian (mesodermal) tumor (MMMT) cells was performed with May-Grünwald-Giemsa and hematoxylin and eosin stain.
  • After more than 20 passages, cells were used to estimate the population-doubling time and colony-forming efficiency of MMMT cells.
  • The cell line exhibited considerable variation in the degree of sensitivity to diverse chemotherapy drugs in vitro.
  • RESULTS: MMMT cells containing antigens for vimentin and myoglobin were detected, but those for CA-125, carcinoembryonic antigen, cytoskeleton, desmin, epithelial membrane antigen and fibronectin were not found.
  • CONCLUSION: The establishment and availability of the number cell line MT-213-VGH for a malignant mixed müllerian tumor of the uterus should assist in research on new methods of managing this type of gynecologic cancer.
  • [MeSH-major] Mixed Tumor, Mullerian. Tumor Cells, Cultured. Uterine Neoplasms

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  • (PMID = 11575644.001).
  • [ISSN] 0001-5547
  • [Journal-full-title] Acta cytologica
  • [ISO-abbreviation] Acta Cytol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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3. Melilli GA, Nappi L, Carriero C, Lapresa M, Loizzi V, Caradonna F, Quaranta M, Putignano G: Malignant mixed mullerian tumor of the ovary: report of four cases. Eur J Gynaecol Oncol; 2001;22(1):67-9
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  • [Title] Malignant mixed mullerian tumor of the ovary: report of four cases.
  • INTRODUCTION: Malignant mixed mullerian tumor (MMMT) of the ovary is an extremely rare gynaecologic neoplasm that represents 1% of the malignances of this organ.
  • Stage I disease is rare because it is asymptomatic in early stage.
  • CASE REPORTS: In the Department of Obstetrics and Gynecology of the University of Bari four cases of MMMT of the ovary were diagnosed.
  • Three patients were in stage IIIC and one of them was a homologous MMMT; the fourth patient was affected by a heterologous stage IV MMMT.
  • All women were treated with surgery and chemotherapy.
  • Two patients are alive 14 and 12 months after diagnosis.
  • CONCLUSIONS: The malignant mixed mullerian tumor (MMMT) of the ovary is a particularly aggressive tumor, especially in advanced stages.
  • The survival rate is very low in spite of surgery, chemotherapy and radiotherapy.
  • The optimal treatment for this neoplasm is unknown because of its rarity.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Middle Aged. Prognosis

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  • (PMID = 11321500.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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4. Mok JE, Kim YM, Jung MH, Kim KR, Kim DY, Kim JH, Kim YT, Nam JH: Malignant mixed müllerian tumors of the ovary: experience with cytoreductive surgery and platinum-based combination chemotherapy. Int J Gynecol Cancer; 2006 Jan-Feb;16(1):101-5
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  • [Title] Malignant mixed müllerian tumors of the ovary: experience with cytoreductive surgery and platinum-based combination chemotherapy.
  • This study reviews the clinical outcome and prognosis of patients with malignant mixed müllerian tumors (MMMTs) of the ovary treated with optimal cytoreductive surgery, leaving no residual disease, and platinum-based chemotherapy.
  • Ten patients diagnosed with MMMT of the ovary after complete surgical staging from February 1993 to February 2004 at Asan Medical Center in Korea were studied retrospectively.
  • All ten patients were treated with optimal cytoreductive surgery, leaving no gross residual disease.
  • Seven patients received ifosfamide/cisplatin chemotherapy, and the remaining three patients received other platinum-based combination chemotherapy.
  • Demographic data, pathologic findings, treatments, and survival time were reviewed.
  • The median survival time of all ten patients was 46 months.
  • Platinum-based combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of ovarian MMMT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Mixed Tumor, Mullerian / drug therapy. Mixed Tumor, Mullerian / mortality. Ovarian Neoplasms / mortality. Ovarian Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Ifosfamide / therapeutic use. Immunohistochemistry. Middle Aged. Neoplasm Staging. Ovariectomy / methods. Probability. Retrospective Studies. Risk Assessment. Sampling Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 16445618.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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5. Viereck V, Huschmand Nia A, Pauer HU, Emons G, Krauss T: [Diagnosis and therapy of uterine sarcoma]. Zentralbl Gynakol; 2002 Nov;124(11):506-10
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  • [Title] [Diagnosis and therapy of uterine sarcoma].
  • [Transliterated title] Diagnostik und Therapie der Uterussarkome.
  • Radical surgery in stage I and II uterine sarcoma removing all tumor manifestations is the only curative therapy option for early stage disease.
  • Larger tumors (> 4 cm) and the presence of lymph node metastasis correlate with a high local recurrence rate.
  • For these tumors adjuvant radiation and/or adjuvant chemotherapy may be recommended after surgical therapy.
  • Adjuvant therapy however, should preferably be considered for uterine stromal sarcomas and mixed mesodermal tumors.
  • The toxicity of radiation and/or chemotherapy is greater than any possible benefit for patients with leiomysarcomas as these tumors rarely respond to radiation or chemotherapy.
  • For advanced (> stage I and II) and recurrent disease, curative therapy options are not available and palliative therapy for these patients has to take into consideration the negative side effects and weigh up quality of life against an often very limited possible benefit of such therapy.
  • [MeSH-major] Sarcoma / diagnosis. Uterine Neoplasms / diagnosis

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  • (PMID = 12796843.001).
  • [ISSN] 0044-4197
  • [Journal-full-title] Zentralblatt für Gynäkologie
  • [ISO-abbreviation] Zentralbl Gynakol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 46
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6. Fowler JM, Blessing JA, Burger RA, Malfetano JH: Phase II evaluation of oral trimetrexate in mixed mesodermal tumors of the uterus: a gynecologic oncology group study. Gynecol Oncol; 2002 May;85(2):311-4
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  • [Title] Phase II evaluation of oral trimetrexate in mixed mesodermal tumors of the uterus: a gynecologic oncology group study.
  • OBJECTIVES: This is a Phase II group-wide study of the Gynecologic Oncology Group to determine the toxicity and objective response rate of trimetrexate (TMTX) in patients with advanced, persistent, or recurrent mixed mesodermal tumors of the uterus who have failed higher priority treatment protocols.
  • The minimum treatment period was one course.
  • Patients who had a complete response, partial response, or stable disease were continued on treatment for at least three courses.
  • Twenty-five patients were evaluable for toxicity, and 21 were evaluable for response, as 4 patients did not complete one course of therapy.
  • Eleven patients had heterologous mixed mesodermal tumor (MMT) and 10 had homologous MMT.
  • CONCLUSION: Oral TMTX has insignificant activity in the treatment of advanced, persistent, and recurrent uterine MMT at the dose and schedule administered.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Mixed Tumor, Mesodermal / drug therapy. Trimetrexate / therapeutic use. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy

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  • [Copyright] (c) 2002 Elsevier Science (USA).
  • (PMID = 11972393.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; UPN4ITI8T4 / Trimetrexate
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7. Lee SJ, Choi YL, Lee EJ, Kim BG, Bae DS, Ahn GH, Lee JH: Increased expression of calpain 6 in uterine sarcomas and carcinosarcomas: an immunohistochemical analysis. Int J Gynecol Cancer; 2007 Jan-Feb;17(1):248-53
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  • These included five LMS, seven endometrial stromal sarcomas, and five uterine carcinosarcomas (malignant mullerian mixed tumor [MMMT]).
  • Formalin-fixed, paraffin-embedded tissue sections were immunostained with anti-Capn6 domain-II (anti-DII) and anti-Capn6 domain-T (anti-DT) antibodies.
  • All 17 tumors expressed the Capn6 protein; this finding was in contrast to the absence of expression of the Capn6 protein in all of the normal control tissues.
  • There were no significant associations between tumor stage and staining intensity by anti-DII (P= 1.000) or anti-DT (P= 0.576).
  • However, there was a marginally significant association between tumor subtype and staining intensity (P= 0.054 and P= 0.053, respectively).
  • The expression of Capn6 had no association with disease-free survival (P= 0.367 and P= 0.166, respectively).
  • This study showed that there were marginally significant associations between tumor subtypes and staining intensity, but no association was found with tumor stage and survival.

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  • (PMID = 17291261.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 3.4.22.- / Calpain
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8. Posligua L, Malpica A, Liu J, Brown J, Deavers MT: Combined large cell neuroendocrine carcinoma and papillary serous carcinoma of the endometrium with pagetoid spread. Arch Pathol Lab Med; 2008 Nov;132(11):1821-4
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  • Neuroendocrine carcinomas of the endometrium are rare tumors that can be pure, combined with endometrioid adenocarcinoma, or a component of malignant mixed müllerian tumor.
  • Recently, a case of combined small cell carcinoma and papillary serous carcinoma of the endometrium was described for the first time.
  • The endometrial carcinoma had a small serous component, but most of the tumor was characterized by solid sheets of medium to large cells with abundant mitotic figures, numerous apoptotic bodies, and foci of necrosis.
  • Following surgery, the patient was treated with radiation therapy and chemotherapy.
  • [MeSH-minor] Cell Differentiation. Combined Modality Therapy. Female. Humans. Middle Aged

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  • (PMID = 18976022.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P50 CA083639; United States / NCI NIH HHS / CA / R01 CA131183
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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9. Yildirim Y, Inal MM, Sanci M, Yildirim YK, Mit T, Polat M, Tinar S: Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases. Int J Gynecol Cancer; 2005 Nov-Dec;15(6):1239-42
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  • [Title] Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases.
  • Tamoxifen (TAM) is widely used in the treatment of breast cancer, and its paradoxical effects on female genital system are well known.
  • The mean time of exposure to TAM was 6 (range 3-11) years, and the mean cumulative dose of drug was 43.82 g.
  • All patients were postmenopausal, and the mean age was 66 (range 61-73) years at the time of the diagnosis of the uterine malignancy.
  • Two (50%) patients had uterine malignant mixed müllerian tumor, and two (50%) had leiomyosarcoma.
  • All patients underwent surgery +/- adjuvant therapy (chemotherapy and/or radiation therapy), and two (50%) patients died because of the sarcoma.
  • In consequence, early detection of TAM-related uterine sarcoma is required for orderly gynecological examination in patients having history of TAM usage for previous breast cancer.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Leiomyosarcoma / chemically induced. Mixed Tumor, Mullerian / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Carcinoma, Ductal, Breast / drug therapy. Carcinoma, Ductal, Breast / therapy. Carcinoma, Lobular / drug therapy. Carcinoma, Lobular / therapy. Combined Modality Therapy. Fatal Outcome. Female. Gynecologic Surgical Procedures. Humans. Mastectomy. Middle Aged. Treatment Outcome

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  • (PMID = 16343223.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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10. Ko ML, Jeng CJ, Huang SH, Shen J, Tzeng CR, Chen SC: Primary peritoneal carcinosarcoma (malignant mixed mullerian tumor): Report of a case with five-year disease free survival after surgery and chemoradiation and a review of literature. Acta Oncol; 2005;44(7):756-60
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  • [Title] Primary peritoneal carcinosarcoma (malignant mixed mullerian tumor): Report of a case with five-year disease free survival after surgery and chemoradiation and a review of literature.
  • Malignant mixed mullerian tumors (MMMTs), also known as carcinosarcoma because they contain both carcinomatous and sarcomatous elements are aggressive tumors, which usually arise in the uterus and ovary.
  • Here we report a case of a primary carcinosarcoma of the pelvic peritoneum with five-year disease-free survival after managing the patient with surgery, chemotherapy and radiotherapy.
  • [MeSH-major] Carcinosarcoma / diagnosis. Mixed Tumor, Malignant / diagnosis. Mixed Tumor, Mullerian / diagnosis. Peritoneal Neoplasms / diagnosis. Peritoneal Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Disease-Free Survival. Female. Humans. Laparotomy. Middle Aged. Radiotherapy Dosage

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  • (PMID = 16227168.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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11. Ferrandina G, Zannoni GF, Martinelli E, Vellone V, Prisco MG, Scambia G: Endometrial carcinoma recurring as carcinosarcoma: report of two cases. Pathol Res Pract; 2007;203(9):677-81
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  • Endometrial carcinosarcoma is a rare, aggressive disease, accounting for approximately 3% of all uterine neoplasms.
  • Case 1. a 58-year-old postmenopausal woman diagnosed to have a poorly differentiated endometrial endometrioid adenocarcinoma (FIGO stage IB) developed an intra-abdominal recurrence of disease after 17 months from diagnosis.
  • Salvage chemotherapy with cisplatin, ifosfamide, epirubicin, and then with taxotere was attempted.
  • A 56-year-old woman with a diagnosis of grade 3 endometrial adenosquamous carcinoma of the endometrium (FIGO stage IIIA) experienced pelvic recurrence after five months from completion of chemotherapy.
  • Definitive histology was malignant mixed mesodermal tumor with focal areas of chondrosarcomatous elements.
  • The patient was triaged to exclusive concomitant chemoradiotherapy and salvage chemotherapy.
  • [MeSH-major] Carcinoma, Adenosquamous / pathology. Carcinoma, Endometrioid / secondary. Carcinosarcoma / secondary. Chondrosarcoma / secondary. Endometrial Neoplasms / pathology. Neoplasm Recurrence, Local / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cell Differentiation. Combined Modality Therapy. Fatal Outcome. Female. Humans. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Salvage Therapy / methods

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  • (PMID = 17646054.001).
  • [ISSN] 0344-0338
  • [Journal-full-title] Pathology, research and practice
  • [ISO-abbreviation] Pathol. Res. Pract.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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12. Huang YT, Huang KG, Ueng SH, Shaw SW: Irradiation-induced uterine malignant mixed müllerian tumor. Taiwan J Obstet Gynecol; 2006 Dec;45(4):353-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Irradiation-induced uterine malignant mixed müllerian tumor.
  • OBJECTIVE: To report a case of a patient with cervical squamous cell carcinoma stage IIIB who was diagnosed with malignant mixed müllerian tumor (MMMT) 5 years after radiotherapy.
  • CASE REPORT: A 57-year-old female patient with cervical squamous cell carcinoma FIGO stage IIIB received pelvic irradiation for her disease.
  • At 60 months, Papanicolaou smear revealed abnormal cancer cells and secondary MMMT was diagnosed.
  • The patient underwent surgical treatment followed by chemotherapy.
  • For patients with any types of symptoms, aggressive and immediate investigation is suggested in order to detect possible occult malignancies.
  • [MeSH-major] Adenocarcinoma / etiology. Carcinoma, Squamous Cell / radiotherapy. Mixed Tumor, Mullerian / etiology. Neoplasms, Radiation-Induced / diagnosis. Uterine Cervical Neoplasms / radiotherapy


13. Allam-Nandyala P, Bui MM, Caracciolo JT, Hakam A: Squamous cell carcinoma and osteosarcoma arising from a dermoid cyst--a case report and review of literature. Int J Clin Exp Pathol; 2010;3(3):313-8
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  • A rare case of multiple malignant tumors (poorly differentiated squamous cell carcinoma and high grade osteosarcoma) arising in an ovarian dermoid cyst of a 55 year old female is reported.
  • To the best of our knowledge, this is the first well documented example of such an unusual combination of tumors arising in a dermoid cyst.
  • The osteosarcoma and squamous cell carcinoma appear to arise in the background of benign teratomatous environment of a dermoid cyst rather than from "pure" mixed mesodermal tumors of the ovary.
  • The tumors did not appear to have well demarcated boundaries with a junction or close intermingling of both cell types, features less favorable for collision tumor or carcinosarcoma.
  • Despite extensive surgery with negative surgical margins and combination chemotherapy, the patient had recurrence of the tumor within four months and she died secondary to septicemia to chemotherapy and bilateral pulmonary emboli shortly after.
  • [MeSH-minor] Combined Modality Therapy. Diagnosis, Differential. Fatal Outcome. Female. Humans. Middle Aged. Ovary / pathology

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  • (PMID = 20224730.001).
  • [ISSN] 1936-2625
  • [Journal-full-title] International journal of clinical and experimental pathology
  • [ISO-abbreviation] Int J Clin Exp Pathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 14
  • [Other-IDs] NLM/ PMC2836509
  • [Keywords] NOTNLM ; Malignant dermoid / osteosarcoma / squamous cell carcinoma / teratoma
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14. Sit AS, Price FV, Kelley JL, Comerci JT, Kunschner AJ, Kanbour-Shakir A, Edwards RP: Chemotherapy for malignant mixed Müllerian tumors of the ovary. Gynecol Oncol; 2000 Nov;79(2):196-200
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  • [Title] Chemotherapy for malignant mixed Müllerian tumors of the ovary.
  • OBJECTIVE: The aim of this study was to review the chemotherapy experience at Magee-Womens Hospital for malignant mixed müllerian tumor (MMMT) of the ovary.
  • Patients were treated with either paclitaxel/carboplatin (PC) outpatient chemotherapy or platinum/ifosfamide (PI) inpatient chemotherapy as first- or second-line therapy.
  • METHODS: Thirteen patients diagnosed with MMMT of the ovary after complete surgical staging from 1990 to 1999 were studied retrospectively.
  • Six patients received PC combination chemotherapy, of which 3 patients received PC as first-line treatment.
  • The other 3 patients received PC as second-line therapy.
  • Demographic data, pathology, cytoreductive surgery, treatment, and survival rates were reviewed.
  • Complete clinical response (CR) was defined as the disappearance of all measurable disease or normalization of elevated CA 125 level after chemotherapy.
  • RESULTS: The median survival time of patients receiving PC was 19 months.
  • One patient, after receiving PC as first-line treatment, demonstrated a CR and is free of disease beyond 33 months.
  • The median survival time of patients managed with PI was 23 months.
  • Three patients with suboptimal disease demonstrated CR after receiving PI.
  • CONCLUSIONS: Optimal chemotherapy regimen for MMMT of ovary remains to be determined.
  • Platinum-based chemotherapy in combination with ifosfamide or paclitaxel may be active against this rare malignancy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mullerian / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Aged. Carboplatin / administration & dosage. Carboplatin / adverse effects. Chemotherapy, Adjuvant. Female. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Platinum / administration & dosage. Platinum / adverse effects. Retrospective Studies. Survival Analysis. Taxoids. Treatment Outcome

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 11063643.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Taxoids; 49DFR088MY / Platinum; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; UM20QQM95Y / Ifosfamide; PC protocol; PI protocol
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15. Silva RG, Dahmoush L, Gerke H: Pancreatic metastasis of an ovarian malignant mixed Mullerian tumor identified by EUS-guided fine needle aspiration and Trucut needle biopsy. JOP; 2006;7(1):66-9
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  • [Title] Pancreatic metastasis of an ovarian malignant mixed Mullerian tumor identified by EUS-guided fine needle aspiration and Trucut needle biopsy.
  • CONTEXT: Malignant mixed Mullerian tumors are rare ovarian neoplasms that account for less than 2% of ovarian malignancies.
  • They have a generally poor prognosis and often develop recurrent disease.
  • To our knowledge, this is the first report of a malignant mixed Mullerian tumor with metastasis to the pancreas.
  • The metastatic tumor was identified by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and Trucut needle biopsy of the pancreas.
  • CASE REPORT: We describe a 69-year-old female with concomitant Duke's C adenocarcinoma of the colon and stage III-C malignant mixed Mullerian tumor that presented with malignant ascites, increasing abdominal girth and a pancreatic head mass.
  • EUS revealed an 11 cm cystic mass in the head of the pancreas that was characterized as a carcinosarcoma/malignant mesodermal mixed tumor by EUS-FNA and Trucut needle biopsy.
  • The tumor was morphologically identical to the surgical specimen of her ovarian mass.
  • The patient was treated with palliative chemotherapy and a three-month follow up CT scan did not reveal any new metastatic lesions.
  • CONCLUSION: The pancreas is a rare site of metastasis and more commonly seen in renal cell carcinoma, melanoma or lung tumors; amongst others.
  • Although ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, it has not been previously described originating from a mixed Mullerian tumor of the ovary presenting as a cystic pancreatic head mass.
  • [MeSH-major] Mixed Tumor, Mullerian / secondary. Ovarian Neoplasms / pathology. Pancreatic Neoplasms / secondary
  • [MeSH-minor] Aged. Biopsy, Fine-Needle / methods. Endosonography. Female. Humans. Neoplasm Staging. Pancreas / pathology. Pancreas / radiography. Prognosis. Tomography, X-Ray Computed


16. Kourea HP, Adonakis G, Androutsopoulos G, Zyli P, Kourounis G, Decavalas G: Fallopian tube malignant mixed müllerian tumor (carcinosarcoma): a case report with immunohistochemical profiling. Eur J Gynaecol Oncol; 2008;29(5):538-42
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  • [Title] Fallopian tube malignant mixed müllerian tumor (carcinosarcoma): a case report with immunohistochemical profiling.
  • We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopian tube in a 69-year-old woman presenting with abdominal pain and an adnexal mass.
  • The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, received adjuvant chemotherapy and is without evidence of disease 12 months postoperatively.
  • The tumor involved the fallopian tube and was composed of in situ and invasive high-grade serous and undifferentiated carcinoma, leiomyosarcoma, rhabdomyosarcoma and undifferentiated sarcoma.
  • The expression of mesothelial-associated antigens WT1, calretinin and HBME in MMMT likely reflects the common embryologic derivation of the mesothelium and urogenital ridge.
  • Loss of nuclear WT1 expression in the mesenchymal component may be involved in MMMT tumorigenesis.
  • [MeSH-minor] Aged. Antigens, CD56 / analysis. Antigens, CD57 / analysis. Calbindin 2. Female. Humans. Immunohistochemistry. S100 Calcium Binding Protein G / analysis. Tumor Suppressor Protein p53 / analysis. WT1 Proteins / analysis

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  • (PMID = 19051831.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antigens, CD56; 0 / Antigens, CD57; 0 / CALB2 protein, human; 0 / Calbindin 2; 0 / S100 Calcium Binding Protein G; 0 / Tumor Suppressor Protein p53; 0 / WT1 Proteins
  • [Number-of-references] 15
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17. Rouas L, Regragui A, Oukabli M, Amrani M, Gamra L, Otmani A, Bellabas MA: [Uterine carcinosarcoma in a teenager: report of a case macroscopically mimicking rhabdomyosarcoma]. Rev Med Liege; 2005 Dec;60(12):911-4
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  • Uterine carcinosarcoma (malignant mixed mullerian tumor) is uncommon.
  • We report the case of a 17-year-old patient who complained of pelvic pain and abnormal genital bleeding, and had a voluminous hemorrhagic tumor protruding through the vaginal os.
  • The histopathologic and immunohistochemical evaluation led to the diagnosis of uterine carcinosarcoma.
  • Adjuvant chemotherapy was given.
  • In spite of the surgical treatment, the evolution was fatal with widespread metastases.
  • From data of the literature, we discuss the diagnosis, histogenesis and treatment of this rare tumor.
  • [MeSH-major] Carcinosarcoma / diagnosis. Uterine Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Diagnosis, Differential. Fatal Outcome. Female. Humans. Rhabdomyosarcoma / diagnosis

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  • (PMID = 16457389.001).
  • [ISSN] 0370-629X
  • [Journal-full-title] Revue médicale de Liège
  • [ISO-abbreviation] Rev Med Liege
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Belgium
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18. Matsuura Y, Kitajima M, Hachisuga T, Tanimoto A, Okura N, Kihara I: Malignant mixed müllerian tumor with malignant neuroectodermal components (teratoid carcinosarcoma) of the ovary: Report of a case with clinicopathologic findings. J Obstet Gynaecol Res; 2010 Aug;36(4):907-11
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  • [Title] Malignant mixed müllerian tumor with malignant neuroectodermal components (teratoid carcinosarcoma) of the ovary: Report of a case with clinicopathologic findings.
  • Malignant mixed müllerian tumor (MMMT) or carcinosarcoma of the female genital tract is a rare neoplasm.
  • Malignant ovarian tumor composed of müllerian epithelial tumor and malignant germ cell tumor is also rare, with most cases composed of endometrioid adenocarcinoma and yolk sac tumor.
  • Ovarian MMMT with malignant neuroectodermal components resembling immature teratoma is extremely rare.
  • The resected tumor measuring over 20 cm in diameter consisted of cystic and solid components and was very fragile.
  • Microscopic examination showed a heterogenous mixed tumor composed of malignant epithelial, malignant mesodermal and malignant neuroectodermal components.
  • There was no tumor immunoreactivity to alpha-fetoprotein, carcinoembryonic antigen, human chorionic gonadotropin, and inhibin.
  • In spite of aggressive combination chemotherapy and three times of laparotomy, the patient died of disease 3 years 10 months after the initial treatment.
  • This quite rare ovarian tumor closely resembled nasopharyngeal tumors described as 'teratoid carcinosarcoma' is biologically aggressive.
  • Further cases need to be accumulated to make diagnosis and to determine a successful treatment modality.
  • [MeSH-major] Carcinosarcoma / pathology. Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology. Teratoma / pathology

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  • (PMID = 20666968.001).
  • [ISSN] 1447-0756
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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19. Wei CF, Hwang SH, Ho CM, Shih BY, Chien TY: Malignant mixed müllerian tumors of the ovary. Zhonghua Yi Xue Za Zhi (Taipei); 2000 Apr;63(4):344-8
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  • [Title] Malignant mixed müllerian tumors of the ovary.
  • Malignant mixed Müllerian tumor (MMMT) of the ovary is very rare, and to the best of our knowledge, only a few cases have been reported in the literature from Taiwan.
  • We report two recent cases of ovarian MMMT at our hospital.
  • Case 1 was a 59-year-old female with stage IIIC MMMT of the ovary, with a tumor having carcinomatous and sarcomatous elements.
  • The sarcomatous component was composed of a homologous malignant mesenchymal element with conspicuous hyaline globules.
  • The patient died of the disease six months after debulking surgery.
  • Case 2 was a 42-year-old female with ovarian stage IIC MMMT.
  • The patient died of the disease four months after debulking surgery.
  • These two patients both underwent hysterectomy, bilateral salpingo-oophorectomy and omentectomy and both received platinum-based chemotherapy after debulking surgery.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology

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  • (PMID = 10820916.001).
  • [ISSN] 0578-1337
  • [Journal-full-title] Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi (Taipei)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] CHINA
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20. Ulbricht LJ, Kunert M, Gremmler B, Evagelopoulos N, Krian A, Moege J: Intracardiac metastasis of a Malignant Mixed Mullerian tumor (MMMT): progressive dyspnoea due to obstruction of the left atrium and the left ventricle without left ventricular dysfunction or primary lung disease. Wien Med Wochenschr; 2009;159(13-14):355-8
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  • [Title] Intracardiac metastasis of a Malignant Mixed Mullerian tumor (MMMT): progressive dyspnoea due to obstruction of the left atrium and the left ventricle without left ventricular dysfunction or primary lung disease.
  • Malignant Mixed Mullerian tumors (MMMT) are rare gynecological tumors.
  • Even with surgical treatment, chemotherapy, and/or radiotherapy, outcome is poor.
  • In a 61-year-old female patient who had undergone surgical resection of a Mullerian tumor of the uterus 26 months prior to being admitted to our department, we found an obstructing left atrial mass.
  • Histopathologic assessment of this lesion after surgical resection revealed a Mullerian tumor metastasis.
  • On a literature review, we did not find any description of left atrial and left ventricular occluding metastases of MMMT.
  • [MeSH-major] Dyspnea / etiology. Heart Atria. Heart Neoplasms / diagnosis. Heart Ventricles. Mixed Tumor, Mullerian / diagnosis. Mixed Tumor, Mullerian / secondary. Uterine Neoplasms / diagnosis. Ventricular Function, Left / physiology
  • [MeSH-minor] Disease Progression. Echocardiography. Echocardiography, Transesophageal. Female. Humans. Middle Aged. Palliative Care. Tomography, X-Ray Computed


21. Fotiou S, Hatjieleftheriou G, Kyrousis G, Kokka F, Apostolikas N: Long-term tamoxifen treatment: a possible aetiological factor in the development of uterine carcinosarcoma: two case-reports and review of the literature. Anticancer Res; 2000 May-Jun;20(3B):2015-20
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  • [Title] Long-term tamoxifen treatment: a possible aetiological factor in the development of uterine carcinosarcoma: two case-reports and review of the literature.
  • Two cases of uterine carcinosarcoma developing after long-term tamoxifen (TAM) treatment are presented.
  • They both developed an heterologous malignant mixed Mullerian tumor (mmMt).
  • At laparotomy, an advanced stage of disease was found with peritoneal spread.
  • In spite of the surgical and the postoperative treatment, they both died of disease, 3 and 10 months later.
  • Another 7 were identified in series of uterine malignancies developing after TAM treatment.
  • Considerable evidence suggests that mmMt represents an epithelial cancer with sarcomatous dedifferentiation.
  • Prolonged (> 5 years) TAM treatment may represent a causative factor in the development of this highly lethal disease (80% of the reported patients had a dismal prognosis).
  • Large uterine polyps with special histological features, may represent an intermediate step in the tumor formation.
  • [MeSH-major] Adenocarcinoma / chemically induced. Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Carcinosarcoma / chemically induced. Mixed Tumor, Mullerian / chemically induced. Neoplasms, Second Primary / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Ductal, Breast / drug therapy. Carcinoma, Ductal, Breast / surgery. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Mastectomy. Methotrexate / administration & dosage. Ovariectomy. Peritoneal Neoplasms / secondary. Polyps / chemically induced

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  • (PMID = 10928144.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] GREECE
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen; 8N3DW7272P / Cyclophosphamide; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate; CMF regimen
  • [Number-of-references] 42
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22. Curtis RE, Freedman DM, Sherman ME, Fraumeni JF Jr: Risk of malignant mixed mullerian tumors after tamoxifen therapy for breast cancer. J Natl Cancer Inst; 2004 Jan 7;96(1):70-4
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  • [Title] Risk of malignant mixed mullerian tumors after tamoxifen therapy for breast cancer.
  • Recent studies have indicated that the tamoxifen-related risk of uterine corpus cancer may be especially high for some uncommon cell types, although the magnitude of risk has not been quantified.
  • The relative risk was substantially higher for malignant mixed mullerian tumors (MMMTs) (O/E = 4.62, O = 34, 95% CI = 3.20 to 6.46) than for endometrial adenocarcinomas (O/E = 2.07, O = 306, 95% CI = 1.85 to 2.32), although the excess absolute risk was smaller-an additional 1.4 versus 8.4 cancers per 10 000 women per year, respectively.
  • These findings indicate that tamoxifen may have delayed effects, such as the increased risk of MMMTs, rare but aggressive tumors of unclear pathogenesis.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Estrogen Receptor Modulators / adverse effects. Mixed Tumor, Mullerian / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Adenocarcinoma / chemically induced. Adult. Aged. Carcinoma, Ductal / drug therapy. Confidence Intervals. Female. Humans. Middle Aged. Odds Ratio. Risk Assessment. Time Factors

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  • (PMID = 14709741.001).
  • [ISSN] 1460-2105
  • [Journal-full-title] Journal of the National Cancer Institute
  • [ISO-abbreviation] J. Natl. Cancer Inst.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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23. Chiu SY, Twu NF, Lai CH, Yen MS, Chao KC: Primary malignant mixed müllerian tumor of the ovary. Taiwan J Obstet Gynecol; 2010 Mar;49(1):87-90
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  • [Title] Primary malignant mixed müllerian tumor of the ovary.
  • OBJECTIVE: To present a case of malignant mixed müllerian tumor of the ovary, a rare and aggressive ovarian malignant tumor with poor prognosis.
  • Physical examination and computerized tomography revealed cystic mass lesions on the bilateral adnexal areas.
  • Optimal debulking surgery was performed, and final pathology revealed malignant mixed müllerian tumor of the ovary.
  • Chemotherapy using ifosfamide and cisplatin were administered postoperatively, and adjuvant was also administered.
  • After six cycles of chemotherapy, the patient is well with no signs of recurrence.
  • CONCLUSION: Ovarian malignant mixed müllerian tumor usually yields poor outcomes; hence, aggressive treatment with optimal debulking surgery followed by combination chemotherapy using ifosfamide and cisplatin may improve patient outcomes.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Female. Humans. Ifosfamide / therapeutic use. Middle Aged

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  • (PMID = 20466300.001).
  • [ISSN] 1875-6263
  • [Journal-full-title] Taiwanese journal of obstetrics & gynecology
  • [ISO-abbreviation] Taiwan J Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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24. Curtin JP, Blessing JA, Soper JT, DeGeest K: Paclitaxel in the treatment of carcinosarcoma of the uterus: a gynecologic oncology group study. Gynecol Oncol; 2001 Nov;83(2):268-70
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  • [Title] Paclitaxel in the treatment of carcinosarcoma of the uterus: a gynecologic oncology group study.
  • OBJECTIVE: The goal of this study was to estimate the clinical activity of paclitaxel in patients with persistent or recurrent carcinosarcoma of the uterus who have failed other treatments.
  • METHODS: The Gynecologic Oncology Group (GOG) conducted a phase II study of paclitaxel 170 mg/m(2) (135 mg/m(2) in those with prior irradiation) intravenously every 3 weeks in patients with histologic confirmation of carcinoma and measurable disease who had failed appropriate local therapy.
  • Twenty-six patients had heterologous mixed mesodermal tumors (MMTs) and 18 patients had homologous tumors.
  • Fifteen patients had previous radiation therapy and 33 patients had failed prior chemotherapy.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Carcinosarcoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Paclitaxel / therapeutic use. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Humans. Infusions, Intravenous. Middle Aged

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11606082.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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25. Hsieh CL, Chang TC, Lai CH, Jung SM, Chou HH: Excellent progression-free survival with liposomal doxorubicin for a patient with recurrent ovarian malignant mixed müllerian tumor: case report and literature review. Gynecol Oncol; 2004 Sep;94(3):854-7
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  • [Title] Excellent progression-free survival with liposomal doxorubicin for a patient with recurrent ovarian malignant mixed müllerian tumor: case report and literature review.
  • INTRODUCTION: Ovarian malignant mixed müllerian tumor (MMMT) is a rare, highly aggressive, fatal disease.
  • Optimal cytoreduction surgery plus platinum-based combination chemotherapy are associated with better outcomes.
  • CASE REPORT: A 65-year-old patient of stage IIIc ovarian MMMT having obtained a 41-month remission after four courses of aggressive surgical debulking procedures, platinum-containing chemotherapy, and intraoperative radiotherapy suffered from multi-focal recurrences and obtained another 22-month progression-free survival after treatment with monthly liposomal doxorubicin (Lipo-Dox) for 14 courses and Lipo-Dox/carboplatin for subsequent 6 courses without obvious toxicity.
  • DISCUSSION: Liposomal doxorubicin might be useful as salvage chemotherapy for heavily pretreated, recurrent ovarian MMMT.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Doxorubicin / therapeutic use. Neoplasm Recurrence, Local / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Carboplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Middle Aged

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  • (PMID = 15350389.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 80168379AG / Doxorubicin; BG3F62OND5 / Carboplatin
  • [Number-of-references] 10
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26. Kanjeekal S, Chambers A, Fung MF, Verma S: Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol; 2005 May;97(2):624-37
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  • [Title] Systemic therapy for advanced uterine sarcoma: a systematic review of the literature.
  • OBJECTIVE: To conduct a systematic review of the literature regarding the systemic treatment of advanced uterine sarcoma and provide an evidence-based summary of the available literature.
  • "Uterine sarcoma," "leiomyosarcoma," "mixed mesodermal tumor," "chemotherapy," and "systemic therapy" were combined with the search terms for study designs.
  • In a randomized trial of doxorubicin versus doxorubicin plus cyclophosphamide for advanced or recurrent uterine sarcoma, doxorubicin produced an overall response rate (RR) of 19% and median survival of 11.6 months, which was similar to the response with combination chemotherapy (RR 19%, median survival 10.9 months).
  • A randomized trial comparing ifosfamide plus cisplatin versus ifosfamide alone in mixed mesodermal tumors showed a significant improvement in RR and progression-free survival with the combination compared with ifosfamide alone, however, the combination was associated with increased toxicity including death.
  • CONCLUSIONS: Offering palliative chemotherapy to patients with advanced, unresectable uterine sarcoma who are symptomatic from this disease is a reasonable decision.
  • The combination of cisplatinum and ifosfamide is also an option for women with metastatic mixed mesodermal tumors; however, this combination is associated with significant toxicity when compared to ifosfamide alone.
  • [MeSH-major] Mixed Tumor, Mesodermal / drug therapy. Sarcoma, Endometrial Stromal / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Clinical Trials, Phase II as Topic. Female. Humans. Leiomyosarcoma / drug therapy. Randomized Controlled Trials as Topic

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  • (PMID = 15863170.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 43
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27. Hudelist G, Unterrieder K, Kandolf O, Alpi G, Pucher S, Pollak G, Czerwenka K, Keckstein J: Malignant mixed Müllerian tumor with heterologous component arising in the fallopian tube--a case report. Eur J Gynaecol Oncol; 2006;27(5):509-12
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  • [Title] Malignant mixed Müllerian tumor with heterologous component arising in the fallopian tube--a case report.
  • Primary malignant mixed Müllerian tumors (MMMTs) of the fallopian tube are rarities in gynecologic oncology with only 26 cases of MMMTs with a heterologous component reported thus far.
  • We report a case of FIGO Stage II primary MMMT of the fallopian tube with a heterologous tumor portion in an 80-year-old woman presenting with abdominal discomfort at the time of primary diagnosis.
  • After performance of total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy follow-up examination three months postoperatively did not show signs of disease recurrence.
  • The patient finally presented six months after the initial diagnosis with extensive intraabdominal metastasis and died several days thereafter.
  • The efficacy of chemotherapy and radiation remains to be defined in future studies.
  • [MeSH-major] Fallopian Tube Neoplasms / diagnosis. Mixed Tumor, Mullerian / diagnosis

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  • (PMID = 17139989.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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28. Brown E, Stewart M, Rye T, Al-Nafussi A, Williams AR, Bradburn M, Smyth J, Gabra H: Carcinosarcoma of the ovary: 19 years of prospective data from a single center. Cancer; 2004 May 15;100(10):2148-53
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  • BACKGROUND: A review of clinicopathologic features and outcome in women with carcinosarcoma of the ovary (also known as malignant mixed mesodermal tumor [MMMT]) compared with a group of women with serous adenocarcinoma (SAC) of the ovary was conducted.
  • METHODS: Between 1984 and 2002, 1568 patients with epithelial ovarian carcinoma and 70 patients with ovarian carcinosarcoma underwent treatment at the Edinburgh Cancer Centre.
  • Analysis was performed on 65 patients with MMMT, and 746 patients with SAC were selected as a group for comparison.
  • Baseline variables were recorded prospectively and response to chemotherapy and progression-free and cause-specific survival between the groups were compared.
  • The objective response rate to platinum-based chemotherapy was found to be significantly lower in patients with carcinosarcoma (25% vs. 60%; P = 0.02).
  • Achieving optimal debulking at the time of initial surgery was found to be a highly significant factor in patients with carcinosarcoma with regard to determining outcome (median survival of 14.8 months for patients with optimally debulked International Federation of Gynecology and Obstetrics Stage III disease vs. 3.1 months for patients with suboptimally/nondebulked Stage III disease; P < 0.001).
  • CONCLUSIONS: Ovarian carcinosarcoma is a distinct entity with a poor prognosis.
  • Patients with carcinosarcoma differ from those with SAC with regard to having an older mean age of onset, an inferior response to platinum-based chemotherapy, and worse progression-free and cause-specific survival.
  • The extent of benefit from chemotherapy is unclear.
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Cystadenoma, Serous / drug therapy. Cystadenoma, Serous / mortality. Cystadenoma, Serous / pathology. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prospective Studies. Survival Rate

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15139057.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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29. Zhang C, Li XP, Cui H, Shen DH, Wei LH: Advanced primary peritoneal carcinoma: clinicopathological and prognostic factor analyses. J Zhejiang Univ Sci B; 2008 Jun;9(6):435-40
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  • RESULTS: There were 15 cases of primary peritoneal serous papillary carcinoma (PPSPC), 6 cases of mixed epithelial carcinoma (MEC) and 3 cases of malignant mixed Mullerian tumor (MMMT).
  • Among those receiving first-line chemotherapy, 13 patients received the TP regimen (paclitaxel-cisplatin or carboplatin) and 7 patients received the PAC regimen (cisplatin-doxorubicin-cyclophosphamide).
  • The median overall survival of all patients was 42 months, while the breakdown for survival time for patients with PPSPC, MMT and MEC was 44, 13 and 19 months, respectively.
  • There were significant differences in the median survival between patients with PPSPC and those with MMMT (44 months vs 13 months, P<0.05), also between patients receiving TP combination and those receiving the PAC regimen (75 months vs 28 months, P<0.05).
  • Another significant difference in the median progression-free survival (PFS) was identified between patients with positive p53 immunostaining and those with negative p53 immunostaining (15 months vs 47 months, P<0.05), whereas age, menopausal status, residual tumor size and the other molecular factors did not significantly impact survival.
  • CONCLUSION: Patients with PPC should be treated with a comprehensive management plan including appropriate cytoreductive surgery and responsive chemotherapy.
  • The pathologic subtype, chemotherapy regimen and p53 overexpression were significant prognostic factors.
  • [MeSH-minor] Adult. Aged. Antigens, Neoplasm / metabolism. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / metabolism. China / epidemiology. Combined Modality Therapy. Cystadenocarcinoma, Papillary / metabolism. Cystadenocarcinoma, Papillary / mortality. Cystadenocarcinoma, Papillary / pathology. Cystadenocarcinoma, Papillary / therapy. DNA Topoisomerases, Type II / metabolism. DNA-Binding Proteins / metabolism. Female. Humans. Immunohistochemistry. Ki-67 Antigen / metabolism. Middle Aged. Mixed Tumor, Mullerian / metabolism. Mixed Tumor, Mullerian / mortality. Mixed Tumor, Mullerian / pathology. Mixed Tumor, Mullerian / therapy. Ovarian Neoplasms / metabolism. Ovarian Neoplasms / mortality. Ovarian Neoplasms / pathology. Ovarian Neoplasms / therapy. Prognosis. Receptor, ErbB-2 / metabolism. Survival Rate. Tumor Suppressor Protein p53 / metabolism

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  • [Cites] Gynecol Oncol. 2001 Jul;82(1):99-104 [11426969.001]
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  • (PMID = 18543395.001).
  • [ISSN] 1673-1581
  • [Journal-full-title] Journal of Zhejiang University. Science. B
  • [ISO-abbreviation] J Zhejiang Univ Sci B
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Ki-67 Antigen; 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53; EC 2.7.10.1 / ERBB2 protein, human; EC 2.7.10.1 / Receptor, ErbB-2; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
  • [Other-IDs] NLM/ PMC2408695
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30. Ma CJ, Yang SF, Huang CC, Chai CY, Cheng KI, Tsai EM, Wang JY: Malignant mixed müllerian tumor of primary mesenteric origin associated with a synchronous ovarian cancer: case report and literature review. Eur J Gynaecol Oncol; 2008;29(3):289-93
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  • [Title] Malignant mixed müllerian tumor of primary mesenteric origin associated with a synchronous ovarian cancer: case report and literature review.
  • Malignant mixed müllerian tumor (MMMT) is a rare tumor in females and extragenital MMMT is even more so.
  • We report a patient with MMMT primarily in the mesentery with synchronous ovarian cancer.
  • In the English literature, 42 cases of extragenital MMMT have been reported other than the presented case, and this is only the second MMMT arising from the mesentery.
  • Furthermore, among the cases reviewed, MMMTs tend to be associated with synchronous or metachronous colonic cancer or gynecologic tumors originating from the müllerian duct, including ovarian tumors, fallopian tube cancer, endometrial cancer, cervical cancer, and serous carcinoma of the peritoneum (14 out of 43 patients; 32.6%).
  • The risk factors for MMMT include obesity, nulliparity, exogenous estrogen, and long-term tamoxifen use.
  • The prognosis of MMMT is catastrophic and the treatment is based on the experience of those of uterine sarcomas, which is composed of operation, radiotherapy and chemotherapy.
  • [MeSH-major] Adenocarcinoma / surgery. Mesentery / pathology. Mixed Tumor, Mullerian / pathology. Neoplasm Recurrence, Local / therapy. Ovarian Neoplasms / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. Fallopian Tube Neoplasms / drug therapy. Fallopian Tube Neoplasms / pathology. Fallopian Tube Neoplasms / surgery. Female. Humans. Middle Aged. Neoplasms, Multiple Primary / pathology. Neoplasms, Multiple Primary / surgery. Postmenopause


31. Inthasorn P, Beale P, Dalrymple C, Carter J: Malignant mixed mullerian tumour of the ovary: prognostic factor and response of adjuvant platinum-based chemotherapy. Aust N Z J Obstet Gynaecol; 2003 Feb;43(1):61-4
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  • [Title] Malignant mixed mullerian tumour of the ovary: prognostic factor and response of adjuvant platinum-based chemotherapy.
  • OBJECTIVES: The purpose of the present study was to analyse retrospectively the data of a series of patients presenting to our unit with malignant mixed mullerian tumour (MMMT) of the ovary to identify the prognostic factors and relate them to survival.
  • The role of platinum-based chemotherapy in the adjuvant treatment of this tumour was also evaluated.
  • METHODS: All patients diagnosed with MMMT of the ovary from 1987 to 2000 were identified from the gynaecological tumour registry of King George V Hospital, Australia.
  • The response of platinum-based adjuvant chemotherapy after surgery was also evaluated.
  • RESULTS: Twenty patients with MMMT of the ovary were identified.
  • Of the six patients with measurable disease, two (33%) had complete response after adjuvant platinum-based chemotherapy.
  • The median survival of all patients was 8 months, while that of the patients receiving adjuvant platinum-based chemotherapy was 23 months.
  • CONCLUSIONS: Malignant mixed mullerian tumour of the ovary is a rare and aggressive gynaecological tumour.
  • The current study indicates that patient age was a significant prognostic factor for survival and surgical cytoreduction combined with platinum-based chemotherapy is the most effective management regimen identified to date to treat MMMT of the ovary.
  • [MeSH-major] Mixed Tumor, Mullerian / therapy. Ovarian Neoplasms / therapy. Platinum Compounds / therapeutic use
  • [MeSH-minor] Age Factors. Aged. Chemotherapy, Adjuvant. Female. Humans. Hysterectomy. Ovariectomy. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 12755351.001).
  • [ISSN] 0004-8666
  • [Journal-full-title] The Australian & New Zealand journal of obstetrics & gynaecology
  • [ISO-abbreviation] Aust N Z J Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Platinum Compounds
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32. Müller H, Nakchbandi V: Cytoreductive surgery plus intraperitoneal hyperthermic perfusion is an effective treatment for metastasized malignant mixed mesodermal tumours (MMMT)--report of six cases. Eur J Surg Oncol; 2004 Jun;30(5):573-7
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  • [Title] Cytoreductive surgery plus intraperitoneal hyperthermic perfusion is an effective treatment for metastasized malignant mixed mesodermal tumours (MMMT)--report of six cases.
  • BACKGROUND: Malignant mixed mesodermal tumours (MMMT) of the female genital tract are rare and heterogeneous malignancies that impart grim prognosis.
  • These tumours are characterized by an admixture of malignant epithelial and stromal elements comprising carcinomatous and sarcomatous neoplastic cells.
  • Thus far, almost 350 cases of MMMT have been recorded in the international medical literature.
  • Due to its rarity, there is no agreement on the best treatment strategy in women with metastasized MMMT.
  • METHODS: Six women (mean age 59 years) with metastasized MMMT defined to the peritoneal cavity have been treated by cytoreductive surgery plus hyperthermic peritoneal perfusion plus postoperative adjuvant chemotherapy.
  • All patients have been pre-treated by surgery for primary tumour and one by systemic chemotherapy.
  • As adjuvant treatment CDDP 40 mg/m2/dl, Mitomycin 7 mg/md2/dl and Ifosfamid 100 mg/kg 24 h/dl was applicated via intraaortic catheter three times with a treatment free interval of 3 weeks.
  • RESULTS: A complete cytoreduction without remnant tumour formations in the peritoneal cavity could be carried out in all six patients.
  • One patient died 4 months later by pneumonia without evidence of disease.
  • Four patients are without evidence of disease after 2, 4, 14 and 19 months, whereas one patient developed liver metastases after 9 months still treated by systemic chemotherapy.
  • CONCLUSION: Complete cytoreduction plus hyperthermic peritoneal perfusion plus adjuvant chemotherapy seems to be an effective treatment for recurrent or metastasized MMMT.
  • Further studies have to define the value of this new treatment strategy for this rare tumour entity.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Hyperthermia, Induced. Mixed Tumor, Malignant / secondary. Mixed Tumor, Malignant / therapy. Mixed Tumor, Mesodermal / secondary. Mixed Tumor, Mesodermal / therapy. Peritoneal Neoplasms / pathology. Peritoneal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antibiotics, Antineoplastic / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Germany. Humans. Ifosfamide / administration & dosage. Laparotomy. Liver / pathology. Middle Aged. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Peritoneal Cavity / pathology. Treatment Outcome. Women's Health

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  • [CommentIn] Eur J Surg Oncol. 2005 Feb;31(1):111-2 [15642436.001]
  • (PMID = 15135489.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; 50SG953SK6 / Mitomycin; UM20QQM95Y / Ifosfamide
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33. Hoskins PJ, Le N, Ellard S, Lee U, Martin LA, Swenerton KD, Tinker AV, British Columbia Cancer Agency: Carboplatin plus paclitaxel for advanced or recurrent uterine malignant mixed mullerian tumors. The British Columbia Cancer Agency experience. Gynecol Oncol; 2008 Jan;108(1):58-62
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  • [Title] Carboplatin plus paclitaxel for advanced or recurrent uterine malignant mixed mullerian tumors. The British Columbia Cancer Agency experience.
  • OBJECTIVES: Uterine MMMTs are aggressive malignancies that are rarely cured by purely local therapies.
  • Effective chemotherapy is needed.
  • Carboplatin and paclitaxel (CT) are easy to deliver and is effective against endometrial carcinoma and should be against MMMT (as they are now regarded as epithelial in nature).
  • METHODS: A review of all women with uterine MMMT treated with CT.
  • Dose reduction occurred in 5%, treatment delay in 10%.
  • CONCLUSIONS: Carboplatin-paclitaxel is effective against uterine MMMT, with similar efficacy to ifosfamide combinations.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mullerian / drug therapy. Neoplasm Recurrence, Local / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Retrospective Studies

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  • (PMID = 17935761.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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34. Lee SH, Kim J, Kim JH, Lee KH, Park JS, Hur SY: Malignant mixed mullerian tumor of the cervix including components of a rhabdomyosarcoma: case report and literature review. Eur J Gynaecol Oncol; 2010;31(4):462-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant mixed mullerian tumor of the cervix including components of a rhabdomyosarcoma: case report and literature review.
  • Malignant mixed mesodermal tumors (MMMTs) are composed of carcinomatous and sarcomatous components and have an aggressive metastatic potential, resulting in a poor prognosis.
  • Due to the rarity of MMMTs arising from the cervix, there is no consensus regarding treatment, prognosis, and outcome; however, aggressive surgical cytoreduction, combined with adjuvant platinum-based chemotherapy and/or radiotherapy, is recommended as the treatment of choice for MMMTs of the cervix.
  • Cervical MMMTs are more often confined to the uterus at the time of diagnosis and frequently have non-glandular epithelial components.
  • A case of an immunohistochemically confirmed primary MMMT of the cervix, including components of a rhabdomyosarcoma, is reported.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Rhabdomyosarcoma / pathology. Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Immunohistochemistry. Middle Aged


35. Dumortier J, Freyer G, Sasco AJ, Frappart L, Zénone T, Romestaing P, Trillet-Lenoir V: Endometrial mesodermal mixed tumor occurring after tamoxifen treatment: report on a new case and review of the literature. Ann Oncol; 2000 Mar;11(3):355-8
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  • [Title] Endometrial mesodermal mixed tumor occurring after tamoxifen treatment: report on a new case and review of the literature.
  • BACKGROUND: Anti oestrogenic treatment is widely used for breast cancer treatment and prevention of recurrence.
  • Although secondary endometrial cancers usually present as pure adenocarcinomas, other types of rare tumors have also been reported.
  • PATIENTS AND METHODS: Herein we describe the clinical, pathological as well as therapeutic aspects of a new case of endometrial mesodermal mixed tumor occurring after long-term tamoxifen therapy.
  • RESULTS: The present case occured five years after cessation of a five years tamoxifen treatment.
  • The patient failed to respond to doxorubicin and cyclophosphamide when combined to 5-fluorouracil (5-FU), but she reached complete response when the same two drugs were used with carboplatin, suggesting the potential usefullness of platinum derivatives.
  • CONCLUSIONS: A longer latency period might be observed for endometrial mesodermal mixed tumors as compared to adenocarcinomas and could justify a prolonged clinical and ultrasonographic follow-up of patients during and after tamoxifen treatment.
  • When indicated, chemotherapy might require the use of platinum derivatives in this particular type of secondary tumor.

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  • (PMID = 10811505.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Carcinogens; 094ZI81Y45 / Tamoxifen; BG3F62OND5 / Carboplatin
  • [Number-of-references] 24
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36. Takano M, Shibasaki T, Sato K, Aida S, Kikuchi Y: Malignant mixed Mullerian tumor of the uterine corpus with alpha-fetoprotein-producing hepatoid adenocarcinoma component. Gynecol Oncol; 2003 Nov;91(2):444-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant mixed Mullerian tumor of the uterine corpus with alpha-fetoprotein-producing hepatoid adenocarcinoma component.
  • OBJECTIVES: Hepatoid adenocarcinoma is a rare tumor and has the histological coexistence of well-differentiated adenocarcinoma and nests of hepatoid cells with immunoreactivity for alpha-fetoprotein (AFP).
  • A case of hepatoid adenocarcinoma in malignant mixed Mullerian tumor of the uterus is presented with a review of the literature.
  • Histologically, the tumor was composed of endometrioid adenocarcinoma, neoplastic hepatoid cells, and sarcoma component including leiomyosarcoma and rhabdomyosarcoma.
  • After operation followed by six courses of platinum-based chemotherapy, serum levels of AFP dropped into normal range.
  • CONCLUSIONS: This is, to our knowledge, the first report of malignant mixed Mullerian tumor of the uterus with an AFP-producing hepatoid adenocarcinoma component.
  • [MeSH-major] Carcinoma, Hepatocellular / metabolism. Carcinoma, Hepatocellular / pathology. Mixed Tumor, Mullerian / metabolism. Mixed Tumor, Mullerian / pathology. Uterine Neoplasms / metabolism. Uterine Neoplasms / pathology. alpha-Fetoproteins / biosynthesis

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  • (PMID = 14599882.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / alpha-Fetoproteins
  • [Number-of-references] 17
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37. Powell MA, Filiaci VL, Rose PG, Mannel RS, Hanjani P, Degeest K, Miller BE, Susumu N, Ueland FR: Phase II evaluation of paclitaxel and carboplatin in the treatment of carcinosarcoma of the uterus: a Gynecologic Oncology Group study. J Clin Oncol; 2010 Jun 01;28(16):2727-31
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  • [Title] Phase II evaluation of paclitaxel and carboplatin in the treatment of carcinosarcoma of the uterus: a Gynecologic Oncology Group study.
  • PURPOSE: Platinum and taxane compounds have demonstrated activity in uterine carcinosarcoma (malignant mixed Mullerian tumor).
  • PATIENTS AND METHODS: Eligible patients had advanced stage (III or IV), persistent or recurrent measurable disease, and no prior chemotherapy.
  • Patients received paclitaxel at 175 mg/m(2) intravenously (IV) over 3 hours plus carboplatin (area under the serum concentration-time curve = 6) IV over 30 minutes every 3 weeks until disease progression or until adverse effects occurred.
  • Treatment was well tolerated with expected hematologic toxicity and minimal nonhematologic grade 4 toxicity (one cardiovascular and two pain) with 59% of patients completing six or more cycles of chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinosarcoma / drug therapy. Carcinosarcoma / mortality. Uterine Neoplasms / drug therapy. Uterine Neoplasms / mortality
  • [MeSH-minor] Aged. Aged, 80 and over. Biopsy, Needle. Carboplatin / administration & dosage. Carboplatin / adverse effects. Confidence Intervals. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Immunohistochemistry. Infusions, Intravenous. Kaplan-Meier Estimate. Maximum Tolerated Dose. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Probability. Prognosis. Program Evaluation. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 20421537.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / U10 CA027469; United States / NCI NIH HHS / CA / U10 CA037517; United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2881851
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38. Crotzer DR, Wolf JK, Gano JB, Gershenson DM, Levenback C: A pilot study of cisplatin, ifosfamide and mesna in the treatment of malignant mixed mesodermal tumors of the ovary. Gynecol Oncol; 2007 May;105(2):399-403
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  • [Title] A pilot study of cisplatin, ifosfamide and mesna in the treatment of malignant mixed mesodermal tumors of the ovary.
  • PURPOSE: To evaluate the efficacy and toxicity of cisplatin and ifosfamide in the treatment of patients with malignant mixed mesodermal tumor (MMMT) of the ovary.
  • METHODS: Ten patients with histologically confirmed primary MMMT of the ovary diagnosed between 1993 and 2001 were enrolled in the study.
  • Treatment consisted of cisplatin 75 mg/m2 on day 1, followed by ifosfamide 2.0 g/m2 over 24 h on days 1, 2 and 3.
  • Chemotherapy was repeated on a 28-day cycle if blood counts permitted.
  • RESULTS: Eight of the nine patients responded to therapy, with 7 complete responses (78%) and 1 partial response.
  • One patient remained free of disease 94.4 months after diagnosis, and one patient remained alive with recurrence 125.5 months following diagnosis.
  • CONCLUSION: The combination of cisplatin and ifosfamide/mesna demonstrated activity against MMMT of the ovary.
  • Novel agents with activity against MMMT of the ovary and acceptable toxicity are needed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mesodermal / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Female. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Mesna / administration & dosage. Mesna / adverse effects. Middle Aged. Neoplasm Staging. Pilot Projects

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  • (PMID = 17292457.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] NR7O1405Q9 / Mesna; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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39. Nappi L, Indraccolo U, Matteo M, Rosenberg P, Greco P: Malignant mixed müllerian tumor of the fallopian tube coincident with a primary serous carcinoma of the ovary. Case report. Eur J Gynaecol Oncol; 2007;28(6):511-2
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  • [Title] Malignant mixed müllerian tumor of the fallopian tube coincident with a primary serous carcinoma of the ovary. Case report.
  • Malignant mixed müllerian tumors are very rare neoplasms of the fallopian tube, and treatment is not well defined.
  • A case of malignant mixed müllerian tumor of the tube concomitant with a primary serous carcinoma of the ovary is reported.
  • It was unclear if there were two distinct neoplasms in the same patient, or if it was a single tumor with a sarcomatous fallopian conversion of the serous component, as described for some recurrent ovarian carcinomas.
  • Chemotherapy for ovarian carcinoma with intraperitoneal metastasis was performed, with about a three-year interval-free period of disease, as could be expected for ovarian carcinomas at the same stage.
  • Such coexistence of these two tumors does not afford adequate staging of the malignancy.
  • Therapy for the very rare cases similar to the one reported here needs to be improved.
  • [MeSH-major] Fallopian Tube Neoplasms / complications. Mixed Tumor, Mullerian / complications. Ovarian Neoplasms / complications

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  • (PMID = 18179150.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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40. Ben-Shachar I, Pavelka J, Cohn DE, Copeland LJ, Ramirez N, Manolitsas T, Fowler JM: Surgical staging for patients presenting with grade 1 endometrial carcinoma. Obstet Gynecol; 2005 Mar;105(3):487-93
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  • METHODS: The charts of all patients who presented for surgery for endometrial cancer between March 1997 and July 2003 were analyzed for demographic data, final tumor histology, grade, stage, and complications.
  • Preoperatively, 181 (52%) were identified with grade 1 disease, with a mean age of 61 years (range 27-89).
  • Surgical staging (pelvic +/- para-aortic lymphadenectomy) was performed in 82% of cases and was omitted only in cases when disease was apparently confined to the endometrium and surgical risk was high.
  • In comparison of pre- and postoperative histology, 19% of patients were upgraded, with 15% grade 2, 0.5% grade 3, 2.5% serous or clear cell, and 1% mixed mesodermal tumor.
  • No patients with stage Ia-IIb endometrioid cancer received adjuvant teletherapy or chemotherapy.
  • Four patients with low-risk uterine features were found to have extrauterine disease.
  • Twelve percent of patients received adjuvant therapy, and 17% avoided teletherapy and/or chemotherapy based on surgical staging.
  • CONCLUSION: Surgical staging in patients presenting with grade 1 endometrial cancer significantly impacted postoperative treatment decisions in 29% of patients.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Aorta. Biopsy. Combined Modality Therapy. Dilatation and Curettage. Female. Humans. Hysterectomy. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Pelvis

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  • (PMID = 15738013.001).
  • [ISSN] 0029-7844
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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41. Wang X, Tangjitgamol S, Liu J, Kavanagh JJ: Response of recurrent uterine high-grade malignant mixed müllerian tumor to letrozole. Int J Gynecol Cancer; 2005 Nov-Dec;15(6):1243-8
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  • [Title] Response of recurrent uterine high-grade malignant mixed müllerian tumor to letrozole.
  • Uterine malignant mixed müllerian tumor (MMMT) is a rare malignancy occurring most often in postmenopausal women.
  • Despite the use of multimodality treatments including surgery, chemotherapy, and radiotherapy, prognosis is still poor in most cases.
  • We report the case of a 69-year-old woman with recurrent metastatic high-grade MMMT that responded to letrozole, an aromatase inhibitor.
  • At the initial diagnosis of high-grade uterine MMMT in February 2001, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and postoperative pelvic radiotherapy.
  • Two years later, an asymptomatic retroperitoneal mass was discovered on surveillance abdominal computed tomography scanning.
  • The patient declined radiation or chemotherapy.
  • Treatment with letrozole was begun at 2.5 mg daily.
  • Serial computed tomography scans demonstrated marked tumor shrinkage; after 11 months of letrozole therapy, the tumor had shrunk to less than 25% of its original volume.
  • Further study of letrozole for high-grade uterine MMMT is warranted.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Mixed Tumor, Mullerian / drug therapy. Neoplasm Recurrence, Local / drug therapy. Nitriles / therapeutic use. Triazoles / therapeutic use. Uterine Neoplasms / drug therapy

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  • (PMID = 16343224.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Nitriles; 0 / Triazoles; 7LKK855W8I / letrozole
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42. Cryns P, Roofthooft NJ, Tjalma WA: Malignant mixed müllerian tumor of the ovary and false negative punctures. Eur J Gynaecol Oncol; 2003;24(1):70-2
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  • [Title] Malignant mixed müllerian tumor of the ovary and false negative punctures.
  • Malignant mixed müllerian tumour (MMMT) of the ovary is a rare and aggressive tumour with a poor prognosis.
  • We present a case of a 57-year-old woman with a large pelvic mass, omental cake, ascites and pleural effusions, clinically highly suspect of an ovarian neoplasm.
  • Paracentesis and ultrasound-guided biopsy of the ovary were negative for malignant disease.
  • The latter gave a histopathologic diagnosis of an endometrioid adenocarcinoma of the ovary.
  • However after cytoreductive surgery anatomopathologic examination revealed a malignant mixed müllerian tumour of the ovary with heterologous differentiation.
  • Adjuvant chemotherapy, active against the sarcomatous and the carcinomatous component, was given.
  • At present the patient is well and disease free 35 months after the initial diagnosis.
  • Cytological examination of ascites may be negative in the presence of malignant disease.
  • If a tumour consists of two components, puncture can miss one, which may lead to undertreatment.
  • [MeSH-major] Adenocarcinoma / pathology. Mixed Tumor, Malignant / pathology. Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Biopsy, Needle. Combined Modality Therapy. Diagnosis, Differential. False Negative Reactions. Female. Follow-Up Studies. Humans. Immunohistochemistry. Middle Aged. Neoplasm Staging. Ovariectomy / methods. Risk Assessment. Treatment Outcome

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  • (PMID = 12691322.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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43. Ozguroglu M, Bilici A, Ilvan S, Turna H, Atalay B, Mandel N, Sahinler I: Determining predominating histologic component in malignant mixed müllerian tumors: is it worth it? Int J Gynecol Cancer; 2008 Jul-Aug;18(4):809-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Determining predominating histologic component in malignant mixed müllerian tumors: is it worth it?
  • Malignant mixed müllerian tumors (MMMT) are highly aggressive tumors, usually diagnosed in advanced stage.
  • Cases of MMMT derive from either ovary or uterus.
  • In our study, we investigated the role of carcinomatous and sarcomatous component on response to chemotherapy and disease outcome.
  • We retrospectively analyzed 25 patients with MMMT who were treated in our outpatient clinic from 1998 to 2003.
  • All the paraffin specimens were reevaluated according to the histopathologic features (primary site and percentages of carcinomatous and sarcomatous component) and the effect of predominant histologic type on response to treatment.
  • Primary tumor sites were ovary and endometrium in 36% and 64% of patients, respectively.
  • Ten of 25 patients (40%) were treated with a combination chemotherapy regimen of cisplatin-ifosfamide (PI) and 7 patients (28%) were treated with paclitaxel-carboplatin (PC) protocol.
  • Despite chemotherapy, 17.6% of patients had progressive disease.
  • The remaining 13 patients (54.2%) responded to chemotherapy.
  • MMMT are highly chemoresponsive tumors, irrespective of primary site.
  • Predominating histopathologic feature (carcinoma or sarcoma) should be taken into consideration in predicting the response and planning the chemotherapy regimen.
  • [MeSH-major] Mixed Tumor, Mullerian / diagnosis. Mixed Tumor, Mullerian / pathology. Uterine Neoplasms / diagnosis. Uterine Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Planning Techniques. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 17892455.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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44. Aygun B, Kimpo M, Lee T, Valderrama E, Leonidas J, Karayalcin G: An adolescent with ovarian osteosarcoma arising in a cystic teratoma. J Pediatr Hematol Oncol; 2003 May;25(5):410-3
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  • A 14-year-old girl had an abdominal mass with the characteristics of an ovarian germ cell tumor on computed tomography scan.
  • Seven months after completion of chemotherapy, there were simultaneous local recurrence and lung metastases.
  • Previously, 10 cases of ovarian osteosarcoma have been reported in the literature: 5 were primary osteosarcoma of the ovary, 4 were associated with teratomas, and 1 was part of a malignant mixed mesodermal tumor of the ovary.
  • Of the 10, there are only 2 long-term survivors, both of whom were treated with adjuvant chemotherapy following complete resection.


45. Topuz E, Eralp Y, Aydiner A, Saip P, Taş F, Yavuz E, Salihoğlu Y: The role of chemotherapy in malignant mixed mullerian tumors of the female genital tract. Eur J Gynaecol Oncol; 2001;22(6):469-72
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  • [Title] The role of chemotherapy in malignant mixed mullerian tumors of the female genital tract.
  • Thirteen patients with malignant mixed mullerian tumor of the female genital tract, treated and followed in our clinic from 1989 to 1999 were retrospectively evaluated.
  • Seven patients (53.8%) with advanced disease or postoperative residual tumor were treated with adjuvant chemotherapy.
  • The median age at diagnosis was 64 years (range: 26-79).
  • Tumors were localized to the endometrium in five (62.5%), to the ovaries in two (25%) and to the fallopian tube in one (12.5%) patient.
  • Six patients received cisplatinum-based chemotherapy (4 had doxorubicin including combinations), while one patient was treated with a doxorubicin+ifosphamide combination.
  • Five patients (71.4%) had a complete response (CR) to chemotherapy.
  • Response duration in patients with a CR was +13, +67, +10, +14 and +2 months, respectively.
  • After a median follow-up period of 20 months (3-115 months), six patients have died, five are being followed-up with no evidence of disease, one is alive with metastatic disease and one patient is under treatment.
  • Malignant mixed mullerian tumor of the female genital tract is highly responsive to multimodality treatment strategies.
  • Further prospective studies are required to identify distinct prognostic groups that may benefit from various treatment modalities.
  • [MeSH-major] Genital Neoplasms, Female / drug therapy. Mixed Tumor, Mullerian / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Combined Modality Therapy. Female. Humans. Middle Aged

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  • (PMID = 11874086.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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46. Hubalek M, Ramoni A, Mueller-Holzner E, Marth C: Malignant mixed mesodermal tumor after tamoxifen therapy for breast cancer. Gynecol Oncol; 2004 Oct;95(1):264-6
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  • [Title] Malignant mixed mesodermal tumor after tamoxifen therapy for breast cancer.
  • Especially rare endometrial tumors seem to develop more frequently under tamoxifen therapy.
  • A recent analysis showed a substantially higher risk for malignant mixed mesodermal tumor (MMMT; designated in the WHO classification of female genital tract neoplasms as carcinosarcoma) in association with tamoxifen intake.
  • CASE: We are reporting a case of a 40-year-old multiparous premenopausal woman who received tamoxifen 20 mg daily for 2 years after the surgical treatment of breast cancer and subsequent adjuvant chemotherapy.
  • Two years after initiation of tamoxifen treatment, the patient developed an MMMT of the uterus.
  • More than 64 months after radical hysterectomy, salpingo-oophorectomy, and pelvic lymphadenectomy, she remains recurrence-free for MMMT.
  • Unfortunately, she developed a local recurrence of her breast cancer in 2003.
  • After surgical treatment, she is currently being treated with anastrozole.
  • CONCLUSION: We are reporting a rare case of a premenopausal patient who developed a MMMT within short time of tamoxifen exposure for stage I breast cancer.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Mixed Tumor, Mesodermal / chemically induced. Neoplasms, Second Primary / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced

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  • (PMID = 15385144.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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47. Kawaguchi W, Itamochi H, Kigawa J, Kanamori Y, Oishi T, Shimada M, Sato S, Sato S, Terakawa N: Chemotherapy consisting of paclitaxel and carboplatin benefits a patient with malignant mixed müllerian tumor of the fallopian tube. Int J Clin Oncol; 2008 Oct;13(5):461-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy consisting of paclitaxel and carboplatin benefits a patient with malignant mixed müllerian tumor of the fallopian tube.
  • Malignant mixed müllerian tumors (MMMT) of the fallopian tube are extremely rare, and optimal therapy for them is unknown.
  • Pathological examination determined International Federation of Gynecology and Obstetrics (FIGO) stage IIIc MMMT of the right fallopian tube.
  • The patient received three courses of chemotherapy, consisting of 175 mg/m(2) paclitaxel and AUC=5 carboplatin (TC therapy), administered at 3-week intervals.
  • The tumor attached to the sigmoid colon had shrunk by 60% after chemotherapy.
  • The patient received an additional five courses of adjuvant TC therapy.
  • The patient is alive and free of disease 28 months after the debulking surgery.
  • TC therapy may be effective for MMMT of the fallopian tube.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Fallopian Tube Neoplasms / drug therapy. Mixed Tumor, Mullerian / drug therapy. Paclitaxel / administration & dosage
  • [MeSH-minor] Adenocarcinoma / pathology. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Ovariectomy

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  • (PMID = 18946759.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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48. Liao Q, Wang J, Han J: [Clinical and pathological analysis on 106 cases with uterine sarcoma]. Zhonghua Fu Chan Ke Za Zhi; 2001 Feb;36(2):104-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To analyze the clinical features and factors affecting the prognosis of uterine sarcoma with different histological types.
  • METHODS: One hundred and six cases with uterine sarcoma treated were analyzed retrospectively, among which there were 67 cases with leiomyosarcoma (63.2%), 23 with malignant endometrial interstitial sarcomas (21.7%), 16 with malignant Mullerian mixed tumor (15.1%).
  • The patients usually manifested with abnormal vaginal bleeding (67.0%), palpable mass of lower abdomen (32.1%), vaginal discharge (27.4%), pain on lower abdomen (28.4%), symptoms of oppression (25.5%), and discomfort feeling (28.3%). (2) The rate of preoperative diagnosis was 65.9%, especially that of leiomyosarcoma was lowest (42.9%). (3) In treatment, 16.0% of patients was treated by hysterectomy; bilateral salpingo-oophorectomy and pelvic lymphadenectomy; 75.5% of them by hysterectomy and bilateral salpingo-oophorectomy; after operation, 74.5% of them were treated by chemotherapy, 11.3% by radiotherapy, 6.6% by additional progesterone. (4) The survival period of the patients was related to pathologic types and clinical stages and ages of the patients.
  • The patients with leiomyosarcoma are younger and have better prognosis, but the rate of preoperative diagnosis is low.
  • The prognosis of uterine sarcoma is related to pathologic types, clinical stage and ages of the patients.

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  • (PMID = 11783345.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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49. Shen YM, Xie YP, Xu L, Yang KX, Yu N, Yu Y, Wang JH: Malignant mixed müllerian tumor of the fallopian tube: report of two cases and review of literature. Arch Gynecol Obstet; 2010 Jun;281(6):1023-8
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  • [Title] Malignant mixed müllerian tumor of the fallopian tube: report of two cases and review of literature.
  • PURPOSE: Malignant mixed müllerian tumors (MMMT) of the female genital tract is rare and it is extremely rare in the fallopian tube, with fewer than 53 cases reported in the literature.
  • METHODS: We had experienced two cases of MMMT of the fallopian tube.
  • The clinical features, pathologic findings, diagnosis, therapy, and outcome were reviewed.
  • RESULTS: The clinical features and diagnosis were similar to those of primary carcinoma of the fallopian tube.
  • Histologically, the two patients had homologous and heterologous elements mixed müllerian tumors.
  • Treatment has focused on surgery with postoperative chemotherapy.
  • CONCLUSIONS: MMMT of fallopian tube is an uncommon carcinoma in the female genital tract.
  • Cervical cytology and endometrial curettage could raise the suspicion of a tubal malignancy, but diagnosis is not usually made until the time of surgery.
  • The patient survival will improve after surgery and postoperative chemotherapy.
  • [MeSH-major] Fallopian Tube Neoplasms / diagnosis. Fallopian Tube Neoplasms / therapy. Mixed Tumor, Mullerian / diagnosis. Mixed Tumor, Mullerian / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Female. Gynecologic Surgical Procedures. Humans. Middle Aged

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  • (PMID = 20033419.001).
  • [ISSN] 1432-0711
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 18
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50. Duska LR, Garrett A, Eltabbakh GH, Oliva E, Penson R, Fuller AF: Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary. Gynecol Oncol; 2002 Jun;85(3):459-63
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  • [Title] Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary.
  • OBJECTIVE: Malignant mixed müllerian tumor (MMMT) of the ovary is a rare tumor with a dismal prognosis.
  • The most effective therapy is unknown.
  • The current study was undertaken to characterize a group of patients treated as if they had aggressive epithelial ovarian tumors, with cytoreductive surgery and combination paclitaxel/platinum chemotherapy.
  • METHODS: Retrospective analysis of data obtained from tumor registry and hospital records of cases of malignant mixed müllerian tumor between January 1, 1992 and January 1, 2000 treated at the Massachusetts General Hospital, Brigham and Women's Hospital, and University of Vermont was performed.
  • Only patients treated with combination paclitaxel and platinum therapy were included in the analysis.
  • Data were collected regarding cytoreduction, response to chemotherapy, disease-free interval, and survival.
  • RESULTS: Fifty-five patients were identified with MMMT.
  • Twenty-eight patients with a clearly ovarian primary had received treatment with combination paclitaxel and platinum.
  • Paclitaxel and carboplatin was given as second-line therapy in 2 patients who had chemoresponsive but incurable disease; the remaining patients were treated with paclitaxel and platinum therapy as first-line therapy.
  • Treatment was generally well tolerated.
  • Sixteen patients of 26 treated with paclitaxel and platinum as first-line therapy achieved a complete clinical response (55%) and 6 patients achieved partial response for a total response rate of 72%.
  • Optimal cytoreduction was associated with increased time to recurrence (P = 0.001) but not with survival.
  • CONCLUSION: Although treatment fails many patients, a minority of patients with MMMT in this highly selected population do unexpectedly well.
  • An aggressive approach with surgery and combination paclitaxel-platinum chemotherapy appears to offer very effective therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mullerian / drug therapy. Ovarian Neoplasms / drug therapy

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  • (PMID = 12051874.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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51. Callister M, Ramondetta LM, Jhingran A, Burke TW, Eifel PJ: Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys; 2004 Mar 1;58(3):786-96
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  • [Title] Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome.
  • PURPOSE: To determine the survival outcomes, prognostic factors, and patterns of failure in patients with malignant mixed Müllerian tumor (MMMT) of the uterus.
  • METHODS AND MATERIALS: Between 1954 and 1998, 300 patients with clinical Stage I-III MMMT of the uterus were treated with curative intent at The University of Texas M. D.
  • Their hospital records were reviewed to obtain patient and tumor characteristics; details of surgery, radiotherapy (RT), and chemotherapy; and long-term outcome.
  • Forty-eight patients received adjuvant chemotherapy.
  • Women who were postmenopausal or had a history of prior pelvic RT, pain at presentation, clinical Stage II-III disease, uterine enlargement (>/=12 weeks), or an abnormal Papanicolaou smear finding had a significantly poorer prognosis than the other patients in the series.
  • Of the 273 patients who underwent surgery, those who had positive abdominal washings, uterine length >10 cm, or extrauterine spread of disease to the cervix, adnexa, or peritoneum had a significantly worse prognosis than the other patients.
  • At 5 years, the rates of pelvic and distant disease recurrence for the entire group of 300 patients were 38% and 57%, respectively.
  • However, patients treated with pelvic RT had a longer mean time to any distant relapse (17.3 vs. 7.0 months, p = 0.001) than patients treated with surgery alone.
  • The use of adjuvant chemotherapy did not correlate with the survival rate or rate of distant metastasis.
  • CONCLUSION: Adjuvant pelvic RT decreased the risk of pelvic recurrence and may delay the appearance of distant metastases after hysterectomy for MMMT.
  • As more effective systemic chemotherapy is developed to control microscopic distant disease, the role of RT in controlling locoregional disease in the pelvis and abdomen may become more important.
  • Future research should consider programs that integrate surgery, RT, and chemotherapy to maximize the probability of cure.
  • [MeSH-major] Mixed Tumor, Malignant / mortality. Mixed Tumor, Mullerian / mortality. Uterine Neoplasms / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Postmenopause. Postoperative Complications. Prognosis. Radiation Injuries / pathology. Radiotherapy, Adjuvant. Retrospective Studies. Risk Factors. Survival Rate. Treatment Outcome

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  • (PMID = 14967435.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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52. Sutton G, Kauderer J, Carson LF, Lentz SS, Whitney CW, Gallion H, Gynecologic Oncology Group: Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol; 2005 Mar;96(3):630-4
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  • [Title] Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: a Gynecologic Oncology Group study.
  • METHODS: Eligible patients had histologically confirmed carcinosarcoma (mixed mesodermal tumor) and no postoperative radiotherapy following complete resection for clinical stage I or II disease.
  • Patients with previous chemotherapy, or other noncutaneous malignancies, were ineligible.
  • RESULTS: Nine of seventy-six patients enrolled were deemed ineligible and another two who did not receive protocol treatment were inevaluable.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinosarcoma / drug therapy. Mixed Tumor, Mesodermal / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Female. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Infusions, Intravenous. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging

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  • [CommentIn] Gynecol Oncol. 2005 Nov;99(2):521-2; author reply 522-3 [15921731.001]
  • (PMID = 15721404.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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53. Manolitsas TP, Wain GV, Williams KE, Freidlander M, Hacker NF: Multimodality therapy for patients with clinical Stage I and II malignant mixed Müllerian tumors of the uterus. Cancer; 2001 Apr 15;91(8):1437-43
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  • [Title] Multimodality therapy for patients with clinical Stage I and II malignant mixed Müllerian tumors of the uterus.
  • BACKGROUND: The role of adjuvant therapy in the management of patients with malignant mixed Müllerian tumors (MMMT) of the uterus has not been defined.
  • The outcome of planned multimodality therapy for patients with apparent early stage disease was assessed.
  • METHODS: A pilot study was performed on 38 patients with clinical Stage I or II MMMTs of the uterus who were offered treatment according to a standard protocol.
  • The protocol consisted of removal of the uterus, fallopian tubes, and ovaries and surgical staging followed by tailored radiation therapy and chemotherapy, consisting of cisplatin and epirubicin.
  • RESULTS: The overall survival was 74% (28 of 38 patients), with a mean duration of follow-up for survivors of 55 months (range, 17-121 months).
  • The mean time to death from disease was 26 months (range, 7-87 months).
  • The survival rate for those patients who completed treatment according to the multimodality protocol was 95% (20 of 21 patients), with a disease free survival rate of 90% (19 of 21 patients).
  • The overall survival of patients who did not receive the recommended treatment protocol for various reasons was 47% (8 of 17 patients).
  • An analysis of survival curves demonstrated that there was a significant survival advantage for those patients who completed the treatment according to the multimodality protocol (P = 0.01).
  • CONCLUSIONS: In this pilot study, patients with clinical Stage I or II MMMTs who underwent surgical staging and aggressive adjuvant radiation and chemotherapy had an excellent survival rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mullerian / radiotherapy. Mixed Tumor, Mullerian / surgery. Uterine Neoplasms / radiotherapy. Uterine Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Epirubicin / administration & dosage. Female. Humans. Hysterectomy. Middle Aged. Ovariectomy. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11301390.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin
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54. Rebischung C, Pautier P, Morice P, Lhomme C, Duvillard P: Alpha-fetoprotein production by a malignant mixed Müllerian tumor of the ovary. Gynecol Oncol; 2000 Apr;77(1):203-5
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  • [Title] Alpha-fetoprotein production by a malignant mixed Müllerian tumor of the ovary.
  • Elevated levels of alpha-fetoprotein (AFP), a fetal serum protein, usually signal the development of hepatoma or germ cell tumors, including endodermal sinus tumors.
  • We report the case of a 52-year-old woman with an alpha-fetoprotein-producing malignant mixed Müllerian tumor (MMMT) of the ovary.
  • Serum AFP was 5348 ng/ml at diagnosis.
  • Immunohistochemistry confirmed that the carcinomatous component of this biphasic tumor was the seat of AFP production.
  • After three cycles of combination chemotherapy, the patient achieved a complete remission.
  • Serum AFP was strongly correlated with response to treatment.
  • This is the first report of AFP production by a MMMT of the ovary without a yolk sac component.
  • [MeSH-major] Biomarkers, Tumor / biosynthesis. Mixed Tumor, Mullerian / metabolism. Ovarian Neoplasms / metabolism. alpha-Fetoproteins / biosynthesis
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans. Immunohistochemistry. Middle Aged. Prognosis. Treatment Outcome

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 10739713.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins
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55. Ruiz Tovar J, Reguero Callejas ME, Arano Bermejo JI, Capote Armas LF, González-Palacios Martínez F, Cabañas Navarro L: Malignant mixed Mullerian tumors. Clin Transl Oncol; 2006 Feb;8(2):129-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant mixed Mullerian tumors.
  • Malignant mixed Mullerian tumours (MMMTs) are rare neoplasms, highly aggressive and with an extremely poor prognosis, usually arising in elderly postmenopausal women and presenting at an advanced stage.
  • MMMTs derive from the mullerian mesodermus that differentiates in epithelial and stromal elements, both malignant elements.
  • Treatment in 2 patients was hysterectomy with double ooforectomy, and resection of the pelvic mass was the treatment in the third case.
  • Adjuvant radio chemotherapy was administrated in 2 of the 3 cases.
  • Follow-up revealed recurrent pelvic tumour in 1 patient at 59 months, and breast metastases at 20 months in the second one.
  • [MeSH-major] Mixed Tumor, Mullerian / pathology. Uterine Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / secondary. Breast Neoplasms / secondary. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Fatal Outcome. Female. Femoral Neoplasms / secondary. Humans. Hysterectomy. Ifosfamide / administration & dosage. Ilium. Middle Aged. Neoplasms, Second Primary. Ovariectomy. Paclitaxel / administration & dosage. Palliative Care. Pelvic Neoplasms / secondary. Pelvic Neoplasms / surgery. Prognosis. Radiotherapy, Adjuvant. Sarcoma, Ewing. Spinal Neoplasms / secondary

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  • (PMID = 16632428.001).
  • [ISSN] 1699-048X
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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56. Zhang C, Cui H, Zhao Y, Liang XD, Wang CH, Li XP, Shen DH, Wang SJ, Wei LH: [Clinical management and prognostic analysis of primary peritoneal neoplasms]. Zhonghua Fu Chan Ke Za Zhi; 2005 Jul;40(7):464-8
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  • RESULTS: Among 24 cases, 15 patients were diagnosed as serous papillary adenocarcinoma (9 highly and intermediately differentiated, and 6 lowly differentiated), 6 as mixed epithelial carcinoma and 3 as mixed malignant Mullerian tumor (MMMT).
  • Then they received a platinum-based chemotherapy.
  • Thirteen cases received paclitaxel + cisplatin (TP) and 9 received cisplatin + doxorubicin + cyclophosphamide (PAC) combination chemotherapy.
  • Survival for patients with primary peritoneal serous papillary carcinoma (PPSPC), mixed epithelial carcinoma and MMMT was 44, 19 and 13 months respectively, with a significant difference between PPSPC and MMMT (P < 0.05).
  • TP combination therapy may bring longer survival than PAC regimen.
  • Histopathologic types and chemotherapy regimens are the essential factors of the prognosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Peritoneal Neoplasms
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 16080873.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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57. Goldman NA, de Los Angeles MM, Jones JG, Goldberg GL: Malignant mixed mullerian tumor of the uterus in a patient taking raloxifene. Obstet Gynecol; 2005 May;105(5 Pt 2):1278-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant mixed mullerian tumor of the uterus in a patient taking raloxifene.
  • BACKGROUND: Uterine malignant mixed mesodermal tumor is a rare variant of uterine cancer.
  • We report a case of a women in whom a malignant mixed mesodermal tumor was diagnosed while she was taking raloxifene, which is also a selective estrogen receptor modulator.
  • CASE: A malignant mixed mesodermal tumor was diagnosed in a 64-year-old woman with a bicornuate uterus while she was taking raloxifene for osteoporosis prevention.
  • Diagnosis had been delayed secondary to sampling of the other uterine horn.
  • CONCLUSION: There may be an association between raloxifene and the development of malignant mixed mesodermal tumor.
  • Special attention should be paid when attempting to sample the endometrium in patients with mullerian abnormalities.
  • [MeSH-major] Mixed Tumor, Mullerian / chemically induced. Mixed Tumor, Mullerian / pathology. Raloxifene Hydrochloride / adverse effects. Selective Estrogen Receptor Modulators / adverse effects. Uterine Neoplasms / chemically induced. Uterine Neoplasms / pathology
  • [MeSH-minor] Biopsy, Needle. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Immunohistochemistry. Middle Aged. Neoplasm Staging. Osteoporosis, Postmenopausal / diagnosis. Osteoporosis, Postmenopausal / drug therapy. Ovariectomy / methods. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 15863610.001).
  • [ISSN] 0029-7844
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Selective Estrogen Receptor Modulators; 4F86W47BR6 / Raloxifene Hydrochloride
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58. Muller M, Dupre PF, Lucas B, Simon H, Malhaire JP, Guillemet C, Dessogne P, Pradier O: [Carcinosarcoma of the ovary]. J Gynecol Obstet Biol Reprod (Paris); 2007 Jun;36(4):399-402
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Ovarian carcinosarcoma, also called malignant mixed mesodermal tumour, is a rare ovarian tumour representing less than two per cent of ovarian cancers.
  • Carcinosarcoma is an aggressive tumour, which associates some epithelial elements (carcinoma) with a stromal component (sarcoma).
  • This tumour can be found in the female genital tractus, mostly in the uterus.
  • The initial stage of the disease at the diagnostic is considered as the only prognostic factor.
  • There is no existing consensus concerning treatment.
  • Nevertheless, surgical treatment is paramount for the survival of patients.
  • Response rates to chemotherapy are about 20%.
  • [MeSH-major] Carcinosarcoma / diagnosis. Ovarian Neoplasms / diagnosis

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  • (PMID = 17408876.001).
  • [ISSN] 0368-2315
  • [Journal-full-title] Journal de gynécologie, obstétrique et biologie de la reproduction
  • [ISO-abbreviation] J Gynecol Obstet Biol Reprod (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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59. Gagner JP, Mittal K: Malignant mixed Mullerian tumor of the fimbriated end of the fallopian tube: origin as an intraepithelial carcinoma. Gynecol Oncol; 2005 Apr;97(1):219-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant mixed Mullerian tumor of the fimbriated end of the fallopian tube: origin as an intraepithelial carcinoma.
  • BACKGROUND: A paucity of examples of malignant mixed Mullerian tumors (MMMT) of the fimbriated end of the fallopian tube has been reported.
  • CASE: We report a first case of FIGO Stage IV primary MMMT, heterologous type, in the right fimbria of a 77-year-old woman associated with symptomatic pleural spread who succumbed with recurrent disease 12 months after resection and postoperative paclitaxel and carboplatin chemotherapy.
  • CONCLUSIONS: The identification of intraepithelial carcinoma in this tumor lends support to a role of the epithelial component in fimbrial MMMT histogenesis as seen for MMMT at other anatomic sites.
  • Comparison of the clinical management of these tumors shows prolonged survival of patients whose treatment included postoperative pelvic external radiotherapy.
  • [MeSH-major] Carcinoma in Situ / pathology. Fallopian Tube Neoplasms / pathology. Mixed Tumor, Mullerian / pathology

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  • (PMID = 15790462.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 14
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60. Dede M, Gezginç K, Alanbay I, Fidan U, Yenen M: A sarcomatous-type peritoneal malign mixed mullerian tumor implant in association with ovarian adenocarcinoma: a case report. Eur J Gynaecol Oncol; 2008;29(2):193-5
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  • [Title] A sarcomatous-type peritoneal malign mixed mullerian tumor implant in association with ovarian adenocarcinoma: a case report.
  • A rare case of a patient with a histopathological diagnosis of a sarcomatous-type peritoneal malign mixed müllerian tumor implant in association with ovarian adenocarcinoma is reported.
  • At laboratory examination tumor marker CA-125 was 280.4 U/ml (< 35), CA-15-3 was 146.5 U/ml (< 25), whereas other markers were within normal range.
  • A staging laparatomy procedure was applied.
  • Postoperative histopathological diagnosis was reported as malignant mixed mullerian tumor of the ovary, with the ovarian component as poorly differentiated adenocarcinoma, and the metastatic foci over serosal surfaces as a sarcomatous component.
  • Postoperatively six courses of adjuvant and consolidation chemotherapy were administered to the patient.
  • Further studies are needed to set a consensus about evaluation of treatment and prognosis for this kind of pathology.
  • [MeSH-major] Adenocarcinoma / complications. Mixed Tumor, Mullerian / complications. Ovarian Neoplasms / complications. Peritoneal Neoplasms / complications

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  • (PMID = 18459565.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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