Management of Early Stage Uterine Adenosarcoma

Objective: The aim of this research was to review and assess early stage uterine adenosarcoma. Materials and Methods: A retrospective review was performed using the records of 9 patients with early stage adenosarcoma. Results: The median patient age was 60 (range: ages 41–81). Seven patients presented with vaginal bleeding as their primary symptom, and the other 2 patients presented with low abdominal pain. After becoming pregnant, 1 previously nulliparous patient who underwent fertility-preservation surgery had a vaginal delivery before undergoing total hysterectomy. All patients eventually underwent hysterectomy with bilateral salpingo-oophorectomy or bilateral salpingectomy. All patients had stage I disease, and 2 had adenosarcoma with sarcomatous overgrowth (SO). Three patients had recurrent adenosarcoma and died of their disease, 2 with SO and 1 without SO. Conclusions: Early stage adenosarcoma without SO has a favorable prognosis; however, long-term follow-up for potential late recurrences may be required. With adequate counseling, fertility-preservation surgery may be an acceptable option for patients with early stage adenosarcoma without SO. (J GYNECOL SURG 38:66)