Malignant mixed Mullerian tumour of the uterus

Malignant mixed Mullerian tumour (MMMT) of the uterus, also known a uterine carcinosarcoma, is the commonest (up to 50%) uterine sarcoma. They are thought to account for 2-8% of all malignant uterine cancers 1-2. The uterus is the commonest site for malignant mixed Mullerian tumours 1

A uterine MMMT can be either homologous or heterologous. 

Similar to MMMTs in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components. Usually, the epithelial component dominates 2

Prevalent subtypes for the epithelioid component include:

Prevalent subtypes for the sarcomatoid component include:

Uterine MMMTs commonly present as an intracavitary mass with coexistent dilatation of the endometrial canal.

Often hyperechoic on ultrasound 1.

Often heterogeneously hypodense and ill-defined on contrast-enhanced CT 1. Dilatation of uterine cavity can be appreciated the vast majority of cases.

They are not considered to have a pathognomonic appearance on MRI, with appearances often indistinguishable from those of endometrial adenocarcinoma.

However reported general signal characteristics include 3.

  • T1: predominantly isointense to both myometrium (~75%) and endometrium (~70%)
  • T2
    • hyperintense to myometrium (~90%) 
    • either hypo-intense (~55%) or isointense (~41%) to the endometrium
  • C+ dynamic contrast
    • <1 min: hypointense (~40%) or isointense (33%) to myometrium
    • 1-4 min: hypointense (~60%) to myometrium  
    • >4 min: isointense (56%) to myometrium

Like other malignant mixed Mullerian tumours, they are highly aggressive tumours and carry a poor prognosis. 

General considerations include:

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Article information

rID: 13028
System: Gynaecology
Tag: cases
Synonyms or Alternate Spellings:
  • MMMT of Uterus
  • Uterine malignant mixed Mullerian tumours
  • MMMT uterus
  • Malignant mixed mullerian tumour (MMMT) of the uterus
  • Carcinosarcoma of the uterus
  • Uterine carcinosarcoma
  • Carcinosarcoma of uterus

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