Uterine carcinosarcoma
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| 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
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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.