Difference between revisions of "Uterine carcinosarcoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Carcinosarcoma - high mag.jpg | |||
| Width = | |||
| Caption = Carcinosarcoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = biphasic tumour: (1) malignant epithelial component (carcinoma), (2) mesenchymal differentiation ("sarcoma") | |||
| Subtypes = | |||
| LMDDx = [[undifferentiated endometrial sarcoma]], [[adenosarcoma of the uterus]], [[endometrial carcinoma]]s | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[uterus]] - see ''[[uterine tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = +/-previous radiation exposure | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = poor | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Uterine carcinosarcoma''', also known as '''malignant mixed muellerian tumour''' (abbreviated '''MMMT'''), is an uncommon malignant [[Uterine tumours|uterine tumour]]. | '''Uterine carcinosarcoma''', also known as '''malignant mixed muellerian tumour''' (abbreviated '''MMMT'''), is an uncommon malignant [[Uterine tumours|uterine tumour]]. | ||
==General== | ==General== | ||
*Generally considered [[metaplastic carcinoma]]s (putatively arise from epithelial cells only); they are ''not'' true sarcomas.<ref name=pmid25805398>{{Cite journal | last1 = Cantrell | first1 = LA. | last2 = Blank | first2 = SV. | last3 = Duska | first3 = LR. | title = Uterine carcinosarcoma: A review of the literature. | journal = Gynecol Oncol | volume = 137 | issue = 3 | pages = 581-588 | month = Jun | year = 2015 | doi = 10.1016/j.ygyno.2015.03.041 | PMID = 25805398 }}</ref><ref name=pmid25468677>{{Cite journal | last1 = Artioli | first1 = G. | last2 = Wabersich | first2 = J. | last3 = Ludwig | first3 = K. | last4 = Gardiman | first4 = MP. | last5 = Borgato | first5 = L. | last6 = Garbin | first6 = F. | title = Rare uterine cancer: carcinosarcomas. Review from histology to treatment. | journal = Crit Rev Oncol Hematol | volume = 94 | issue = 1 | pages = 98-104 | month = Apr | year = 2015 | doi = 10.1016/j.critrevonc.2014.10.013 | PMID = 25468677 }}</ref> | |||
**Probably represent poorly differentiated [[endometrial carcinoma]] with metaplastic changes.<ref name=pmid19853898>{{Cite journal | last1 = D'Angelo | first1 = E. | last2 = Prat | first2 = J. | title = Uterine sarcomas: a review. | journal = Gynecol Oncol | volume = 116 | issue = 1 | pages = 131-9 | month = Jan | year = 2010 | doi = 10.1016/j.ygyno.2009.09.023 | PMID = 19853898 }}</ref> | |||
** Typically metstasize as [[carcinoma]].<ref name=pmid21309261>{{Cite journal | last1 = Lopez-Garcia | first1 = MA. | last2 = Palacios | first2 = J. | title = Pathologic and molecular features of uterine carcinosarcomas. | journal = Semin Diagn Pathol | volume = 27 | issue = 4 | pages = 274-86 | month = Nov | year = 2010 | doi = | PMID = 21309261 }}</ref> | |||
* Associated with previous radiation exposure. | * Associated with previous radiation exposure. | ||
* Aggressive/poor prognosis;<ref name=pmid15688674>{{Cite journal | last1 = Ivy | first1 = JJ. | last2 = Unger | first2 = JB. | title = Malignant mixed mullerian sarcomas of the uterus--the LSUHSC Shreveport experience. | journal = J La State Med Soc | volume = 156 | issue = 6 | pages = 324-6 | month = | year = | doi = | PMID = 15688674 }}</ref> in one series 5 year survival ~= 30-35%.<ref name=pmid14967435>{{Cite journal | last1 = Callister | first1 = M. | last2 = Ramondetta | first2 = LM. | last3 = Jhingran | first3 = A. | last4 = Burke | first4 = TW. | last5 = Eifel | first5 = PJ. | title = Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. | journal = Int J Radiat Oncol Biol Phys | volume = 58 | issue = 3 | pages = 786-96 | month = Mar | year = 2004 | doi = 10.1016/S0360-3016(03)01561-X | PMID = 14967435 }}</ref> | * Aggressive/poor prognosis;<ref name=pmid15688674>{{Cite journal | last1 = Ivy | first1 = JJ. | last2 = Unger | first2 = JB. | title = Malignant mixed mullerian sarcomas of the uterus--the LSUHSC Shreveport experience. | journal = J La State Med Soc | volume = 156 | issue = 6 | pages = 324-6 | month = | year = | doi = | PMID = 15688674 }}</ref> in one series 5 year survival ~= 30-35%.<ref name=pmid14967435>{{Cite journal | last1 = Callister | first1 = M. | last2 = Ramondetta | first2 = LM. | last3 = Jhingran | first3 = A. | last4 = Burke | first4 = TW. | last5 = Eifel | first5 = PJ. | title = Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. | journal = Int J Radiat Oncol Biol Phys | volume = 58 | issue = 3 | pages = 786-96 | month = Mar | year = 2004 | doi = 10.1016/S0360-3016(03)01561-X | PMID = 14967435 }}</ref> | ||
*Case reports of MMMT in [[ovary]] and [[fallopian tube]]. | *Case reports of MMMT in [[ovary]] and [[fallopian tube]]. | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: | Image: Carcinosarcoma - low mag.jpg | Low mag. (WC) | ||
Image: | Image: Carcinosarcoma - intermed mag.jpg | Intermed. mag. (WC) | ||
Image: | Image: Carcinosarcoma - high mag.jpg | High mag. (WC) | ||
Image: Carcinosarcoma - very high mag.jpg | Very high mag. (WC) | |||
</gallery> | |||
<gallery> | |||
Image: Carcinosarcoma - 2 - intermed mag.jpg | Intermed. mag. (WC) | |||
Image: Carcinosarcoma - 2 - high mag.jpg | High mag. (WC) | |||
Image: Carcinosarcoma - 2 - very high mag.jpg | Very high mag. (WC) | |||
</gallery> | </gallery> | ||
www: | www: | ||
*[http://path.upmc.edu/cases/case227.html MMMT - case 1 - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case227.html MMMT - case 1 - several images (upmc.edu)]. | ||
*[http://path.upmc.edu/cases/case328.html MMMT - case 2 - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case328.html MMMT - case 2 - several images (upmc.edu)]. | ||
==IHC== | |||
Features: | |||
*CD10 +ve/-ve (16 +ve of 27<ref name=pmid21161468>{{Cite journal | last1 = Koivisto-Korander | first1 = R. | last2 = Butzow | first2 = R. | last3 = Koivisto | first3 = AM. | last4 = Leminen | first4 = A. | title = Immunohistochemical studies on uterine carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma: expression and prognostic importance of ten different markers. | journal = Tumour Biol | volume = 32 | issue = 3 | pages = 451-9 | month = Jun | year = 2011 | doi = 10.1007/s13277-010-0138-1 | PMID = 21161468 }}</ref>). | |||
*SMA -ve/+ve (11 +ve of 27<ref name=pmid21161468/>). | |||
*Desmin -ve/+ve (9 +ve of 27<ref name=pmid21161468/>). | |||
*p53 -ve (8 +ve of 27<ref name=pmid21161468/>). | |||
==See also== | ==See also== | ||
*[[Uterine tumours]]. | *[[Uterine tumours]]. | ||
*[[Metaplastic carcinoma]]. | |||
*[[Sarcomatoid carcinoma]]. | |||
==References== | ==References== | ||
Latest revision as of 22:37, 30 May 2018
| Uterine carcinosarcoma | |
|---|---|
| Diagnosis in short | |
 Carcinosarcoma. H&E stain. | |
|
| |
| LM | biphasic tumour: (1) malignant epithelial component (carcinoma), (2) mesenchymal differentiation ("sarcoma") |
| LM DDx | undifferentiated endometrial sarcoma, adenosarcoma of the uterus, endometrial carcinomas |
| Site | uterus - see uterine tumours |
|
| |
| Clinical history | +/-previous radiation exposure |
| Prevalence | uncommon |
| Prognosis | poor |
Uterine carcinosarcoma, also known as malignant mixed muellerian tumour (abbreviated MMMT), is an uncommon malignant uterine tumour.
General
- Generally considered metaplastic carcinomas (putatively arise from epithelial cells only); they are not true sarcomas.[1][2]
- Probably represent poorly differentiated endometrial carcinoma with metaplastic changes.[3]
- Typically metstasize as carcinoma.[4]
- Associated with previous radiation exposure.
- Aggressive/poor prognosis;[5] in one series 5 year survival ~= 30-35%.[6]
- Case reports of MMMT in ovary and fallopian tube.
Microscopic
Features:[7]
- Biphasic tumour:
- Malignant glandular component (adenocarcinoma).
- Malignant stromal component (one of the following):
- Homologous type (tissue native to uterus):
- Smooth muscle (leiomyosarcoma).
- Fibrous tissue (fibrosarcoma).
- Heterologous type (tissue not native to the uterus):
- Skeletal muscle (rhabdomyosarcoma).
- Cartilage (chondrosarcoma).
- Bone (osteosarcoma).
- Undifferentiated sarcoma (pleomorphic undifferentiated sarcoma).
- Homologous type (tissue native to uterus):
DDx:
Images
Low mag. (WC)
Intermed. mag. (WC)
High mag. (WC)
Very high mag. (WC)
Intermed. mag. (WC)
High mag. (WC)
Very high mag. (WC)
www:
IHC
Features:
- CD10 +ve/-ve (16 +ve of 27[8]).
- SMA -ve/+ve (11 +ve of 27[8]).
- Desmin -ve/+ve (9 +ve of 27[8]).
- p53 -ve (8 +ve of 27[8]).
See also
References
- ↑ Cantrell, LA.; Blank, SV.; Duska, LR. (Jun 2015). "Uterine carcinosarcoma: A review of the literature.". Gynecol Oncol 137 (3): 581-588. doi:10.1016/j.ygyno.2015.03.041. PMID 25805398.
- ↑ Artioli, G.; Wabersich, J.; Ludwig, K.; Gardiman, MP.; Borgato, L.; Garbin, F. (Apr 2015). "Rare uterine cancer: carcinosarcomas. Review from histology to treatment.". Crit Rev Oncol Hematol 94 (1): 98-104. doi:10.1016/j.critrevonc.2014.10.013. PMID 25468677.
- ↑ D'Angelo, E.; Prat, J. (Jan 2010). "Uterine sarcomas: a review.". Gynecol Oncol 116 (1): 131-9. doi:10.1016/j.ygyno.2009.09.023. PMID 19853898.
- ↑ Lopez-Garcia, MA.; Palacios, J. (Nov 2010). "Pathologic and molecular features of uterine carcinosarcomas.". Semin Diagn Pathol 27 (4): 274-86. PMID 21309261.
- ↑ Ivy, JJ.; Unger, JB.. "Malignant mixed mullerian sarcomas of the uterus--the LSUHSC Shreveport experience.". J La State Med Soc 156 (6): 324-6. PMID 15688674.
- ↑ Callister, M.; Ramondetta, LM.; Jhingran, A.; Burke, TW.; Eifel, PJ. (Mar 2004). "Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome.". Int J Radiat Oncol Biol Phys 58 (3): 786-96. doi:10.1016/S0360-3016(03)01561-X. PMID 14967435.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 428. ISBN 978-0781765275.
- ↑ 8.0 8.1 8.2 8.3 Koivisto-Korander, R.; Butzow, R.; Koivisto, AM.; Leminen, A. (Jun 2011). "Immunohistochemical studies on uterine carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma: expression and prognostic importance of ten different markers.". Tumour Biol 32 (3): 451-9. doi:10.1007/s13277-010-0138-1. PMID 21161468.