Müllerian adenosarcoma mimicking cervical carcinoma in a 79-year-old woman: diagnostic challenges and laparoscopictreatment: a case report

Uterine Müllerian adenosarcoma rarely presents as a cervical "cancer-like" mass; we report the first detailed case in a 79-year-old woman whose 5-cm exophytic lesion mimicked advanced cervical carcinoma on imaging. She presented with 2 weeks of post-menopausal bleeding and a friable polyp protruding through the cervical os; MRI described a bulky cervical tumour extending into the lower uterine segment, while tumour markers remained normal. Initial biopsy was inconclusive; subsequent excision and hysterectomy revealed FIGO stage Ib1 low-grade adenosarcoma originating from the lower uterine segment with superficial cervical involvement. Laparoscopic total hysterectomy with bilateral salpingo-oophorectomy was performed uneventfully, and at 7 months she remains disease-free. The case underlines that adenosarcoma can masquerade as cervical cancer, emphasises the need for generous tissue sampling and WT1/ER-based immunohistochemistry to define tumour origin, and confirms excellent outcomes with complete surgical excision for stage I disease.