According to the current WHO classification, a malignant uterine neoplasm containing both high-grade adenocarcinoma and malignant stromal (sarcomatous) elements is now best classified as which entity?
- A High-grade endometrioid carcinoma with metaplastic (sarcomatous) differentiation ✓
- B Adenosarcoma
- C Low-grade endometrial stromal sarcoma
- D Benign leiomyoma with degenerative change
Correct answer: A. High-grade endometrioid carcinoma with metaplastic (sarcomatous) differentiation
Explanation
Malignant Mixed Mullerian Tumour, formerly called carcinosarcoma, is now regarded by WHO as a metaplastic variant of poorly differentiated endometrioid carcinoma rather than a true mixed tumour. Both components derive from the same clone, and the carcinomatous element determines metastatic pattern, usually lymphatic and peritoneal. Adenosarcoma is a distinct entity with benign glands and malignant stroma, while low-grade endometrial stromal sarcoma lacks an epithelial component.
Reference: Berek and Novak's Gynecology, 16th ed.
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