Uterine Adenosarcoma: Presentation, Diagnosis, and Management; Highlighting a Rare Entity

Objective: Adenosarcoma is an uncommon cancer of the female genital system that consists of malignant mesenchymal and benign epithelial components. In this article, we evaluated the clinical, investigational, diagnostic, and oncological data of such a rare disease. Methods: In this retrospective descriptive study, the data of the patients treated between January 2011 and October 2024 have been reviewed. The current investigation documented clinicopathological features, treatment, and outcomes. Results: A total of 15 patients have been included. The mean age was 59.4 years, and the mean body mass index was 33.64 kg/m 2 . All patients reported abnormal uterine bleeding. In 14 patients (93.3%), pelvic MRI was used as an imaging modality. Neoadjuvant treatment was not administered to any of the patients. Eight patients (53.3%) underwent a hysterectomy and bilateral salpingo-oophorectomy only, whereas the remaining patients underwent, in addition, an omentectomy, lymphadenectomy, or both. Eleven patients (73.3%) had an immunohistochemical staining confirming their pathological diagnosis. In 9 individuals (60%), sarcomatous overgrowth was observed. Adjuvant therapy was administered to 11 patients (73.3%). The mean follow-up duration was 11.7 months, with 7 patients (46.6%) experiencing relapses. The median disease-free survival was 12 months, and overall survival was 13 months. Conclusion: Adenosarcoma of the uterus is a rare condition with a low prevalence. Surgical resection is the standard of care. There is little evidence to support treatment choices; hence, the oncologist’s clinical judgment must be used.