A case of Mullerian adenosarcoma of the uterus treated with liposomal doxorubicin

Objective. We report on a case of uterine a denosarcoma responsive to treatment with liposomal doxorubicin (Doxil). Methods. The clinical course, histopathology, and radiologic studies of the case were reviewed and are reported. Results. A 69-year-old woman presented to our institution with dehydration and failure to thrive, and recurrent uterine adenosarcoma, 9 months after initial diagnosis. She had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy at the time of diagnosis, followed by two cycles of Ifosfamide and treatment with megestrol acetate. The patient presented to our institution for hospice care placement, severely dehydrated and with lethargy and with recurrent disease in the pelvis and vagina. She underwent treatment with six cycles of liposomal doxorubicin with a marked response. Given the development of Grade II hand-foot syndrome, liposomal doxorubicin was stopped and two cycles of carboplatin/paclitaxel chemotherapy were administered. Given the patient's disease progression on this regimen, surgical cytoreduction for localized recurrent disease was then performed. The patient developed disease recurrence after a 7-month disease-free interval and 2 years after initial diagnosis. Following another two cycles of liposomal doxorubicin, the patient underwent another cytoreductive procedure for recurrent disease. Two months later, the patient expired, 29 months after diagnosis and 20 months after initial treatment with liposomal doxorubicin chemotherapy. Conclusion. Liposomal doxorubicin appears to be active in the treatment of recurrent uterine adenosarcoma. (C) 2003 Elsevier Science (USA). All rights reserved.