Evaluation of Uterine Carcinosarcoma with the Literature
Uterin Karsinosarkomların Literatür Eşliğinde Değerlendirilmesi

Author : İsmail Harmankaya
Number of pages : 152-157

Abstract

Uterine carcinosarcomas have previously been considered a subgroup of uterine sarcomas and have been called Malignant Mixed Mullerian Tumors (MMMT). The tumor consists of epithelial and mesenchymal component. The mesenchymal component can consist of homologous and heterologous elements. The carcinoma component consists of high-grade endometrioid, serous or clear cell endometrial carcinomas. They are usually detected in high stages, the patient usually has acid and omental involvement. Uterine carcinosarcoma cases diagnosed between 2009 and 2018 at Selcuk University Medical Faculty Hospital were retrospectively analyzed. The data were obtained from electronic medical records. Histopathological diagnoses were revised by finding hemotoxylin eosin stained preparations from the pathology archive. Carcinomatous and sarcomatous components were noted. Tumor sizes, presence of myometrial invasion, pelvic lymph node metastases, presence of tumors in the abdominal fluid and presence of omentum involvement were reviewed. It was observed that all 7 patients diagnosed with Carcinosarcoma in our hospital were in the postmenopausal period and the mean age was 67.4 (50-91). The average size of tumors is 9.1 cm (4-15). While 1 case was stage-II, 2 cases were stage I, III and IV. In 2 cases, invasion had less than half of myometrium, and 5 cases had more than half of myometrium. Cervical involvement was observed in 1 case. Six patients underwent lymph node dissection and 2 cases had lymph node metastasis. Carcinosarcoma in the uterus are rare but very aggressive tumors. Pelvic radiation application and tamoxifen use are risk factors for tumor development. It has been shown that there are mutations in carcinosarcoma that can be seen in endometrial and serous carcinomas such as TP53, PTEN, PIK3CA, PPP2R1A, FBXW7 and KRAS. Generally, the epithelial component consists of high-grade endometrioid and serous carcinomas. Tumor tissue of epithelial component is observed in the recurrence and metastasis of the tumor. Compared to serous carcinomas, overall survival, disease-free survival and post-relapse survival times have been shown to be shorter in carcinosarcoma

Keywords

Carcinosarcoma; Uterus; Malignant Mixed Mullerian Tumor

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