mixed Mullerian tumor

悪性ミューラー管混合腫瘍 MMT

WordNet

1. combine (electronic signals); "mixing sounds"
2. add as an additional element or part; "mix water into the drink" (同)mix in
3. the act of mixing together; "paste made by a mix of flour and water"; "the mixing of sound channels in the recording studio" (同)commixture, admixture, mixture, intermixture, mixing
4. an event that combines things in a mixture; "a gradual mixture of cultures" (同)mixture
5. a commercially prepared mixture of dry ingredients (同)premix
6. to bring or combine together or with something else; "resourcefully he mingled music and dance" (同)mingle, commix, unify, amalgamate
7. an abnormal new mass of tissue that serves no purpose (同)tumour, neoplasm

PrepTutorEJDIC

1. 〈複数のもの〉‘を'『混ぜ合わせる』,混合する,混同する / …‘を'混ぜ合わせて作る,調合して作る / …‘を'寄せ集める,まとめる / 〈物が〉(…と)混ざる,混合する《+『with』+『名』》 / 〈人が〉(他の人と)交わる,交際する《+『with』+『名』》 / 〈C〉〈U〉混合 / 〈C〉混合物(食品,薬) / 〈C〉〈U〉(水・火を加えて即席にでき上がる)素(もと),ミックス
2. (異なった成分(要素)のものが)混ざった,混合の,混成の / 男女混合の / 人種(宗教・国籍など)が違う人々の(から成る)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/03/22 19:12:08」(JST)

wiki en

[Wiki en表示]

Mixed Müllerian tumor
Classification and external resources
ICD-O:	8950

A malignant mixed Müllerian tumor, also known as malignant mixed mesodermal tumor, MMMT and carcinosarcoma, is a malignant neoplasm found in the uterus, the ovaries, the fallopian tubes and other parts of the body that contains both carcinomatous (epithelial tissue) and sarcomatous (connective tissue) components. It is divided into two types, homologous (in which the sarcomatous component is made of tissues found in the uterus such as endometrial, fibrous and/or smooth muscle tissues) and a heterologous type (made up of tissues not found in the uterus, such as cartilage, skeletal muscle and/or bone). MMMT account for between two and five percent of all tumors derived from the body of the uterus, and are found predominantly in postmenopausal women with an average age of 66 years. Risk factors are similar to those of adenocarcinomas and include obesity, exogenous estrogen therapies, and nulliparity. Less well-understood but potential risk factors include tamoxifen therapy and pelvic irradiation.

Naming and classification

There is debate over the naming of MMMT; the term carcinosarcoma was formerly used to describe lesions with homologous tumors, and "malignant mixed Müllerian tumor" or "mixed mesodermal tumor" was used to describe heterologous tumors. While "carcinosarcoma" now considered standard, "malignant mixed Müllerian tumor" has a lengthy history within gynecological literature and is expected to continue to be used. The naming issue to a certain extent reflects histological characteristics and development of the tumors, in which the different types of tissues are believed to either develop separately and join into a single mass (the "collision" theory), that an adenocarcinoma stimulates the stroma to create a tumor (the "composition" theory), or that the tumor is the result of a stem cell that differentiates into different cell types (the "combination" theory). "Collision" tumors are normally easily recognized and not considered true MMMTs; the "combination" theory is most widely held, and is due to evidence that the tumors develop from a single line of cells, developing in a fashion similar to the fundus of the uterus from the Müllerian duct - first from a stem cell into a population of cells, that then differentiates into epithelial and stromal components.

There is evidence that some tumors are better explained by the composition theory, due to the aggressive nature of the epithelial cells involved which tend to metastasize much more readily than the sarcomal component. The behavior of MMMT overall is more related to the type and grade of the epithelium than the sarcoma, which suggests the sarcomal portion is an atypical "bystander" than primary driver of the tumor. Despite this, when purely endometrial tumors are compared to MMMTs, the MMMT tumor tends to have a worse prognosis.

Morphology

Carcinosarcoma of the uterus

In gross appearance, MMMTs are fleshier than adenocarcinomas, may be bulky and polypoid, and sometimes protrude through the cervical os. On histology, the tumors consist of adenocarcinoma (endometrioid, serous or clear cell) mixed with the malignant mesenchymal (sarcoma) elements; alternatively, the tumor may contain two distinct and separate epithelial and mesenchymal components. Sarcomatous components may also mimic extrauterine tissues (e.g., striated muscle, cartilage, adipose tissue, and bone). Metastases usually contain only epithelial components.

Prognosis

Outcome of MMMTs is determined primarily by depth of invasion and stage. As with endometrial carcinomas, the prognosis is influenced by the grade and type of the adenocarcinoma, being poorest with serous differentiation. MMMTs are highly malignant; a stage I tumor has an expected five-year survival rate of 50%, while the overall five-year survival rate is less than 20%.

Staging of Uterine MMMTs is as follows:

• Stage I. Carcinoma is confined to the corpus uteri itself.
• Stage II. Carcinoma involves the corpus and the cervix.
• Stage III. Carcinoma extends outside the uterus but not outside the lesser pelvis.
• Stage IV. Carcinoma extends outside the true pelvis or involves the mucosa of the bladder or the rectum.

References

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 子宮癌肉腫の臨床的特徴、診断、病期分類、および治療 clinical features diagnosis staging and treatment of uterine carcinosarcoma
• 2. 子宮肉腫：分類、臨床症状、および診断 uterine sarcoma classification clinical manifestations and diagnosis
• 3. 子宮筋腫と子宮肉腫の識別 differentiating uterine leiomyomas fibroids from uterine sarcomas
• 4. 子宮平滑筋腫（子宮筋腫）の疫学、臨床症状、診断、および自然経過 epidemiology clinical manifestations diagnosis and natural history of uterine leiomyomas fibroids
• 5. 婦人科悪性腫瘍の治療プロトコル treatment protocols for gynecologic malignancies

English Journal

• Sarcomatous Component in Uterine Carcinosarcomas Correlates With Advanced Stage and Poorer Prognosis.

• Podoll MB1, Moghadamfalahi M, Faber E, Bishop JA, Alatassi H.
• International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists.Int J Gynecol Pathol.2017 Mar 17. doi: 10.1097/PGP.0000000000000374. [Epub ahead of print]
• PMID 28319572

• Malignant Mixed Müllerian Tumour of the Uterus: Analysis of 44 Cases.

• Grasso S1, Loizzi V, Minicucci V, Resta L, Camporeale AL, Cicinelli E, Cormio G.
• Oncology.Oncology.2017;92(4):197-204. doi: 10.1159/000452277. Epub 2017 Jan 17.
• PMID 28092915

• PD-L1 Expression in Carcinosarcomas of the Gynecologic Tract: A Potentially Actionable Biomarker.

• Pinto A1, Mackrides N, Nadji M.
• Applied immunohistochemistry & molecular morphology : AIMM.Appl Immunohistochem Mol Morphol.2016 Oct 31. [Epub ahead of print]
• PMID 27801734

Japanese Journal

• 子宮癌肉腫 (特集 稀少がん,原発不明がんの臨床) -- (稀少がんの臨床)

• 原野 謙一,勝俣 範之
• 腫瘍内科 6(6), 563-566, 2010-12
• NAID 40017655946

• Malignant mixed mullerian tumor with malignant neuroectodermal components (teratoid carcinosarcoma) of the ovary : Report of a case with clinicopathologic findings

• MATSUURA Yusuke,KITAJIMA Mitsuyasu,HACHISUGA Toru,TANIMOTO Akihide,OKURA Naohumi,KIHARA Ikuo
• The journal of obstetrics and gynaecology research 36(4), 907-911, 2010-08-01
• NAID 10031121718

• 転移性小脳腫瘍で発見され, 類内膜腺癌と共存していた子宮体部原発の小細胞癌の1例

• 今北 正美,三ノ浦 康彦,大重 友紀,米倉 由香
• 日本臨床細胞学会雑誌 48(6), 400-403, 2009-11-22
• 背景 : 子宮体部原発の小細胞癌はまれで, 腺癌, 腺扁平上皮癌や悪性ミューラー管混合腫瘍などと共存することが知られている. 小脳転移による症状から発見され, 子宮体部原発の類内膜腺癌と小細胞癌が共存したまれな症例を経験したので報告する.症例 : 41 歳, 女性. 後頭部痛, 回転性めまいと嘔吐が出現し, 歩けなくなったため, 近医を受診した. MRI 検査で, 左小脳半球に嚢胞性腫瘤を指摘され …
• NAID 10025946761

Related Links

• Uterus - Malignant Mixed Mullerian Tumor (MMMT)

Home Chapter Home Jobs Conferences Fellowships Books Advertisement Uterus (excludes Cervix) Stromal tumors Malignant Mixed Mullerian Tumor (MMMT) Reviewer: Mohamed Mokhtar Desouki, MD, PhD (see Reviewers page)

• Malignant mixed Mullerian tumour of the uterus

Introduction A malignant mixed Mullerian tumour (MMMT), also termed uterine carcinosarcoma, is an extremely rare tumour, comprising only 1–2% of uterine neoplasms [1]. These tumours are a dedifferentiated or ...

Related Pictures

---

★リンクテーブル★

リンク元	「MMT」「悪性ミューラー管混合腫瘍」
関連記事	「mix」「tumor」「mixed」

「MMT」

　　[★]

• 悪性ミューラー管混合腫瘍 mixed Mullerian tumor
• 徒手筋力テスト manual muscle testing

「悪性ミューラー管混合腫瘍」

　　[★]

英

mixed Mullerian tumor MMT

「mix」

　　[★]

• 混合、混合する、混ぜる

関

admix、admixture、blend、intermingle、merge、mixture、scramble、shuffle、shuffling

　 　 　 　 　 　 　

「tumor」

　　[★]

• n.

• 腫瘍、腫瘤、腫脹

　

「mixed」

　　[★]

• 混合性の

関

combined