Malignant mixed müllerian tumor in ascitic fluid: a case report with a brief review of literature

Exfoliation of neoplastic cells from the malignant mixed müllerian tumor (MMMT) in peritoneal fluid is rare. Here, we report a case. A 55-year-old, postmenopausal woman presented with abdominal mass and ascites. Cytologic examination of the ascitic fluid sample revealed high cellularity with a bimodal population of cells comprising of adenocarcinoma cells and loose aggregates of degenerated stromal-like cells, morphology of which was somewhat better appreciated in Papanicolaou (PAP) stained smears. Nonetheless, due to the degenerative change that affected the stromal-like cells in particular, a preoperative diagnosis of adenocarcinoma was offered. Histologic examination of the total hysterectomy specimen showed features consistent with malignant mixed müllerian tumor (MMMT) of the uterus. The present case emphasizes the importance of a more careful cytologic examination in rare instances of MMMT presenting with ascites. Examination of PAP stained smears is of particular help in identifying the dual population of MMMT