Uterine müllerian adenosarcoma: A clinicopathologic study of 31 cases A. Nasfi * , L. Charfi, K. Mrad, S. Sassi, R. Sellami-Dhouib, R. Doghri, M. Driss, I. Abbes, S. Nechi, W. Jomaa, K. Ben Romdhane * Salah Azaiez Institute, Dept. of Pathology, Tunis, Tunisia Objective: Müllerian adenosarcoma (MA) is a distinctive type of uterine tumor, traditionally regarded as a low-grade variant of mixed müllerian tumors. Method: Thirty one cases of adenosarcoma were examined during a period of 19 years (May 1993 -February 2012 . Results: Thirty tumors were of the uterine corpus and one of the cervix. The mean patient age was 54,2 years (range: 16 to 73 year). The main clinical manifestations were vaginal bleeding and pelvic pain. Physical examination showed cervical/vaginal mass or pelvic mass. Treatment was known in 25 cases: Patients underwent hysterectomy with bilateral salpingo-oophorectomy in 17 cases and lymphadenectomy in 6 cases. Tumor size ranged from 2,5 to 12 cm (mean: 7.1 cm). Microscopically, sarcomatous overgrowth was found in 4 cases (13 %), heterologous elements in 5 (16 %). Eleven cases (35 %) had myometrial invasion involving the internal half of the myometrial thickness in 9 cases, and more than 50 % in 3 cases (9 %). The cervical tumor presented as an endocervical polyp without invasion of the cervical wall. Conclusion: Uterine MA are low-grade neoplasms capable of local recurrence and much less commonly distant metastasis. Surgical excision is the main treatment strategy with a good prognosis in the early stage disease. The 2 most important adverse prognostic factors are deep myometrial invasion and sarcomatous overgrowth.