Malignant mixed Mullerian tumor of the uterus

Case contributed by Matthew Lukies
Diagnosis almost certain

Presentation

Large volume post-menopausal per vaginal bleeding.

Patient Data

Age: 65 years
Gender: Female
  • enlarged uterus with a heterogeneously hypodense mass occupying the endocervical canal and extending into the uterine cavity with minor heterogeneous contrast enhancement

  • preserved fat plane surrounding the uterus with no direct invasion into the rectum or bladder demonstrated

  • no visceral metastases

  • lytic lesions in the lower thoracic and lumbar vertebral bodies, suspicious for metastases, as well as degenerative changes throughout the vertebral column

  • mildly fatty liver, borderline enlarged spleen and diverticulosis

Case Discussion

The lesion in the endocervical canal and uterine cavity had been biopsied via hysteroscopy prior to this CT and was confirmed on histology to be a malignant mixed Mullerian tumor of the uterus (carcinosarcoma).

Post-menopausal per vaginal bleeding is the most common clinical presentation for malignant mixed Mullerian tumor of the uterus, which is typically highly aggressive with poor prognosis.

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