Malignant mixed mullerian tumor (MMMT) of the cervix

Objectives. To characterize the clinical characteristics, therapeutic options, and potential outcomes in patients diagnosed with malignant mixed mullerian tumor (MMMT) of the uterine cervix. Methods. Five women ranging in age from 25 to 66 (mean 49.6 years) were diagnosed with MMMT of the cervix and treated at the University of Iowa Hospitals and Clinics between 1986 and 2001. Data were retrospectively analyzed from available charts and pathological reports with particular attention to patient demographics, presenting symptoms, treatment, and follow-up. Results. Abnormal vaginal bleeding was a common presenting symptom in all but one patient, in whom an abnormal screening Pap smear was the primary reason for referral. FIGO disease staging at initial diagnosis included two patients with stage IB1 (ages 29 and 66 years), two patients with stage IB2 (ages 25 and 64 years), and one patient with stage IVB (age 64 years) MMMT of the cervix. Organ-confined, early stage lesions (stages IB1 and IB2) responded well to regimens of either surgery alone or surgery plus radiation therapy, with no evidence of recurrent disease at last follow-up 28, 35, 42, and 65 months later, respectively. The lone patient with advanced stage IVB disease, however, was unresponsive to both external beam radiation therapy and ifosfamide chemotherapy, and succumbed to disease within 5 months. Conclusions. Cervical MMMT is an uncommon disease, but long-term survival is possible in organ-confined early stage disease with primary therapy.