• Xiaofeng Jin, Ping Zhu, Shufeng Fan, and Jingru Dai.
• Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hang Zhou, Zhejiang, China.
• Medicine (Baltimore). 2023 Dec 15; 102 (50): e36569e36569.

RationaleMalignant mixed Mullerian tumor (MMMT) is also known as carcinosarcoma, mostly occurring in the uterus, and occurred in ovary is very rare. The disease is highly aggressive. Two cases of MMMT of ovary and their imaging characteristics were collected in our study.Patient ConcernsA 77-year-old and an 80-year-old woman were admitted to the obstetrics and gynecology department of our hospital on June 22, 2019, and December 10, 2019, respectively. The first patient presented with abdominal distension with poor appetite without obvious triggers. Another patient had been menopausal for 18 years and presented with vaginal bleeding with dull pain in the left lower abdomen without obvious cause.DiagnosesBoth patients underwent pelvic magnetic resonance imaging plain and enhanced scan after admission, which indicated pelvic mass. Postoperative pathology confirmed MMMT in the adnexal region.InterventionsBoth patients underwent total hysterectomy and bilateral adnexectomy.OutcomesPostoperatively, the first patient developed complications such as renal failure and gastrointestinal bleeding and was sometimes unconscious. Symptomatic treatment was not effective, and the patient died about 1 month after discharge. The other patient recovered well after surgery, and imaging examinations confirmed no evidence of regrowth of the tumor during an average 36-month follow-up.LessonsThe disease is highly malignant and progresses rapidly. The elevation of CA125 should be taken seriously. The imaging findings of MMMT has certain characteristics. Multi-sequence magnetic resonance imaging may help to distinguish this disease from other pelvic tumors. Once found, surgical treatment is needed as soon as possible, followed by postoperative adjuvant radiotherapy and chemotherapy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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