Article

Primary malignant mixed müllerian tumor of the ovary.

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
Taiwanese journal of obstetrics & gynecology 03/2010; 49(1):87-90. DOI: 10.1016/S1028-4559(10)60016-2
Source: PubMed

ABSTRACT To present a case of malignant mixed müllerian tumor of the ovary, a rare and aggressive ovarian malignant tumor with poor prognosis.
A 52-year-old woman consulted our outpatient department with complaints of abdominal distention and a firm palpable mass over her lower abdomen. Physical examination and computerized tomography revealed cystic mass lesions on the bilateral adnexal areas. Ovarian cancer was suspected, so the patient underwent exploratory laparotomy. 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.
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.

0 Bookmarks
 · 
85 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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. 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. Eight patients were treated with PI. 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. Kaplan-Meier analysis was used for survival analysis. 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. 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.
    Gynecologic Oncology 12/2000; 79(2):196-200. DOI:10.1006/gyno.2000.5956 · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Thirty-one cases of ovarian carcinosarcoma were identified over a 6-year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P < 0.05) were used to compare variables with outcome. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median follow-up was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7-10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome.
    Gynecologic Oncology 01/2006; 100(1):128-32. DOI:10.1016/j.ygyno.2005.07.119 · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ovarian carcinosarcomas (OCS), also known as malignant mixed müllerian tumors, are uncommon malignancies that carry a poor prognosis. The presentation of OCS is usually indistinguishable from that of epithelial ovarian cancer. Due to its low frequency, prospective trials have been difficult to perform, but there is evidence that OCS are sensitive to platinum-based chemotherapy. Recent studies have shown encouraging results with platinum-ifosfamide and platinum-taxane schedules, which are usually considered the treatment of choice. However, poor performance status at presentation is also a common problem, so that many patients may be unsuitable for combination chemotherapy but may still benefit from single-agent platinum or ifosfamide or, occasionally, from nonplatinum schedules such as ifosfamide plus paclitaxel. Aggressive cytoreductive surgery appears to have a positive impact on outcome and should probably be offered to most patients. However, this procedure has been associated with higher rates of complication in OCS and should only be attempted by experienced (gynecological) surgeons in centers with expertise in the management of gynecological malignancies.
    International Journal of Gynecological Cancer 03/2007; 17(2):316-24. DOI:10.1111/j.1525-1438.2006.00760.x · 1.95 Impact Factor