Introduction/Background Mullerian adenosarcoma is a rare malignancy that generally occurs in the uterine corpus but more uncommonly may be found extrauterine. Ovarian adenosarcoma is extremely rare and often is presented in young women. Most of them are low grade and have à good prognosis except adenosarcoma with sarcomatous overgrowth.

Results A 77-year-old menopausal woman presented with abdominal discomfort. She had severe ascites and increasing level of CA-125, CA 19–9, HE4 tumor markers. After surgery and reviewing the pathological samples, adenosarcoma with sarcomatous overgrowth was diagnosed.

Conclusion Possibility of endometriosis transformation to malignancy even in the postmenopausal women may warrants continuous follow up for early diagnosis of this potentially fatal disease. More studies are needed to find the best therapeutic approach in adenosarcoma with sarcomatous overgrowth.

Disclosures nothing for disclosure