30. Adenosarcoma of the uterus responsive to hormonal therapy: a case report

Aims To review a case of a rare tumour, adenosarcoma of the uterus, and its response to hormonal therapy. Methods Adenosarcoma of the uterus is a rare tumour and there are very limited reports of the use of hormonal therapy in its treatment. One case of mullerian adenosarcoma occurring in the uterus of an 82-year-old woman was reviewed from our institution. We compared routine H&E stained slides and oestrogen and progesterone immunohistochemical stains of the initial biopsy of the tumour with slides of the excision specimen. The excision was made after a period of 3 months of treatment with an aromatase inhibitor, le-trozole. She was deemed unsuitable for other forms of therapy due to her other medical conditions. Results Following the 3 months of treatment with letrozole a repeat MRI revealed a significant decrease in size of the tumour (9.5×4.3×3.7 cm to 4.9×4.2×3.1 cm). The extent of parametrial extension had also decreased. The immunohistochemical stains showed increased intensity and more diffuse expression of oestrogen receptor antigen and possibly progesterone receptor antigen in the post-treatment sample compared to the initial biopsy. Observations There was a noticeable decrease in the size of the adenosarcoma of the uterus and expression/intensity of oestrogen and possibly progesterone receptor antigen following treatment with hormonal therapy. There is only very limited data relating to this method of treatment in the literature. This case highlights the need for further studies on the use of hormonal therapy as a possible therapy in these rare tumours.