Louise writes, of Malignant Mixed Mullerian Tumors: A close family member has this diagnosis at a large teaching hospital in NYC  near where we live.  The physicians are tops but communicate little.  A google search produced some information.  However, the tumor is large and inoperable at the moment.  it involves uterus, cervix and vagina.

Do you have any idea how to get more information on prognosis and treatment of these tumors?

First of all, some definitions:

Mullerian - refers to an embryonic structure from which the tissues of the female reproductive tract develop.  The uterus, vagina, and fallopian tubes are referred to as mullerian structures in this context.

Mixed Tumor - Most tumors come from one type of tissue and are classified accordingly.  For example, a carcinoma arises from epithelial tissue - that means from the covering or lining of the organs and passageways of the body.  A sarcoma arises from bone, muscle, or other supporting or connective tissue.  A mixed tumor has elements of more than one tumor type.  In the case of a mullerian mixed tumor, there would be elements of both carcinoma and sarcoma - in this case, both the lining and connective tissue of the uterus.  Mixed mullerian tumors in the uterus are often classified under uterine sarcomas.  They are also called carcinosarcomas, to show both of their origins.

There have been some suggestions in the research literature that the drug tamoxifen may play a role in the development of some mixed mullerian tumors.  In general, these tumors are quite uncommon.

Treatment - Often treatment information can be found under information about uterine sarcomas.  Check out the Uterine Cancer section on this site, as well as this link about the treatment of uterine sarcomas.  In the case of someone who has such a large tumor, it seems likely that radiation and/or chemotherapy will be suggested to shrink the tumor.  Following that, surgery might be more feasible.  Some studies have shown mixed mullerian tumors to be more responsive to chemotherapy than endometrial carcinomas.

Prognosis - Unfortunately, uterine sarcomas as a group tend to be more aggressive than endometrial cancers, and mixed mullerian tumors are no exception.  As in most cancers, they are most treatable before they have spread.  Sadly, from what you say, it sounds like this case has spread already, at least outside of the uterus.  Of course, I can only tell you about general statistics, which may not apply to any individual case where I'm unaware of many of the details (besides not being a physician!).  But in general, a mixed mullerian tumor that had spread outside the uterus would not carry a favorable long-term prognosis.

My best wishes to you and your family member.  Please keep in touch and let us know how things are going.
 
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