en |
Malignant mixed Mullerian tumour of the prolapsed cervix: A case report
MASSINDE, ANTHONY N.; RUMANYIKA, RICHARD R.; KIHUNRWA, ALBERT; RAMBAU, PETER & MAGOMA, MOKE
Abstract
Malignant mixed Mullerian tumour is a rare gynaecological tumour commonly
presenting with vaginal bleeding, abdominal pain or mass in the uterine cavity, cervix or
vagina. The neoplasms are commonly seen in postmenopausal women although it has been
observed in younger women. Ovaries and the corpus of the uterus are commonly involved,
whereas involvement of the cervix and vagina is rare. A 37 year-old Tanzania lady para 7
with a previous history of two genital polypectomies presented with history of recurrent
vaginal mass which was associated with abnormal vaginal bleeding and foul smelling
discharge. Vaginal examination revealed a prolapsed uterus with giant fungating cervical
mass which was ulcerated, friable, and bled easily on touch. Impression was grade three
uterine prolapse with infected cervical polyp/ cervical sarcoma. Excision of the tumour
through trans-vaginal hysterectomy was performed, no lymphadenopathy was found, no
adnexa abnormalities, and no involvement of the vaginal wall. Histological diagnosis of
Malignant mixed Mullerian tumour of the cervix was made. Patient recovery was
unremarkable; however she was lost to follow up. The patient’s mass was initially suspected
to be prolapsed uterus with decubitus ulcer but the histological results were of a malignant
condition. Lack of clear management guidelines for some rare mixed tumours remains a
challenge for clinicians in low resource settings.
Keywords
Malignant mixed Mullerian tumour; cervix; uterine prolapse; Tanzania
|