Autopsy findings in patients with uterine sarcoma

Fleming, William P.; Peters, William A.; Kumar, Naveen; Morley, George W.

doi:10.1016/0090-8258(84)90176-8

Cited by 53 publications

(18 citation statements)

References 12 publications

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“…Tanı anında uterus dışına yayımın yaygınlığı nedeniyle sürvileri oldukça kötüdür (12). Karsinomlara benzer şekilde karsinosarkomlar da pelvik ve paraaortik lenf nodlarına, pelvik yumuşak dokulara, vajen, peritoneal yüzeylere ve akciğere metastaz yapabilmektedir (13)(14)(15). Metastazların histolojik görünümleri değişken olmakla birlikte, lenfatik ve vasküler boşluklarda pür karsinom alanları, metastatik lezyonlarda daha sıklıkla karsinom alanları ve nadiren hem karsinom hem sarkom alanları izlenmektedir.…”

Section: Discussionunclassified

Uteri̇n Karsi̇nosarkomlar: 18 Olguda Hi̇stopatoloji̇k Gözden Geçi̇rme

et al. 2015

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Objective: Uterine carcinosarcomas are relatively rare tumors with poor prognosis. These tumors were considered as a subset of uterine sarcomas; however currently they are classified within the carcinoma group. Recent studies have revealed that these tumors behave according to the characteristics of the epithelial component. The aim of the study was to discuss the histopathological characteristics of these quite aggressive tumors, which were diagnosed in our clinic, in the light of the literature. Materials and Methods:We performed a retrospective analysis of 18 patients with uterine sarcoma, who were operated at our oncology department between 2004 and 2014. Cases with a pathology result of either carcinosarcoma or malignant mixed Müllerian tumor were included in the study pathologically. Tumor size, presence of myometrial invasion and pelvic lymph node metastases were reviewed. Demographic data were recorded. Staging was performed according to FIGO (1988) protocol.Results: 18 patients were diagnosed with carcinosarcoma. 95% of the patients were in postmenopausal period. The mean age was 64.6 (range 47-85). 13 patients underwent comprehensive surgical staging (total hysterectomy + bilateral salpingo-oophorectomy + pelvic para-aortic lymphadenectomy + omentectomy + appendectomy). 5 patients with advanced stage disease underwent suboptimal debulking. 7 patients were stage I and 11 patients were stage II-IV. Myometriyal invasion was present in 17 patients and for 9 of these patients the invasion was observed in more than ½ of the myometrium. Lymphovascular invasion was observed in 11 patients. Conclusion: Uterine carcinosarcomas are extremely aggressive neoplasms. Although they used to be categorized under the group of sarcoma, recent studies have shown that uterine carcinosarcomas are high-grade endometrial carcinomas, which include sarcomatous metaplasia. First-line treatment for uterine carcinosarcomas is surgery. Adjuvant chemotherapy and radiation therapy combinations are used as complementary therapies.

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Section: Discussionunclassified

Uteri̇n Karsi̇nosarkomlar: 18 Olguda Hi̇stopatoloji̇k Gözden Geçi̇rme

et al. 2015

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“…They found 7 pre viously reported cases of leiomyosarcoma and 2 cases of endometrial stromal sarcoma metastatic to the brain. There are other reports where the authors mentioned in passing, or within the body of a table, that women dying of uterine sarcoma had brain metastases [3,12], Moreover, some patients were found to have brain lesions at autopti cal examination [4,13], Hematogenous spread of the tumor first to the lungs and then to the brain has been suggested as the mecha nism of central nervous system metastasis in systemic cancers. This complication, however, is usually consid ered a late event in the course of progressive and/or wide spread disseminated disease [14], In the reported patient, the central nervous system was the only site of detectable metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Involvement Secondary to Metastatic Mixed Müllerian Tumor of the Uterus

Cormio¹,

Colamaria²,

Vagno³

et al. 1997

Gynecol Obstet Invest

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The central nervous system is traditionally considered an uncommon site for metastatic disease from female genital tract tumors. We report the case of a 48-year-old woman with malignant mixed müllerian tumor of the uterus, who developed spinal cord compression by epidural metastasis a few days after the diagnosis of the uterine malignancy. Emergency decompressive laminectomy was performed and a good recovery of the neurological function was achieved. In the following days, while submitted to extensive staging for the uterine malignancy, the patient complained of headache, confusion and visual disturbance. CT scan revealed multiple brain metastases. No other site of metastatic disease could be detected. The patient refused any further treatment and died 1 month later from progressive cerebral disease. Attention should be paid to the possibility of unusual distant metastases associated to uterine sarcoma in order to treat these patients promptly.

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“…According to the biological behavior of US reported from large series it is known that the whole abdominal cavity is at risk for relapse [1,3,11]. This is taken into account by the Gynecological Oncology Group (GOG) in the USA which is currently launching a prospective study evaluating the effect of total abdominal irradiation (30 Gy) with a local boost to the pelvic region (20 Gy; GOG study No.…”

Section: Radiotherapy Of Uterine Sarcomasmentioning

confidence: 99%

“…The patients usually present with postmenopausal bleeding and the diagnosis is made from endometrial curetting. Histology of US encompasses dif ferent types of which the most common arc mixed meso dermal sarcoma (or mixed miillerian sarcomas, MMS), leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) [1]. The clinical behavior of US is characterized both by their tendency to local recurrence and their early hematogenous spread.…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy in the Treatment of Uterine Sarcomas

Hoffmann

Schmandt²,

Kortmann³

et al. 1996

Gynecol Obstet Invest

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Background: In the general population, uterine sarcoma (US) is an uncommon tumor, which accounts for approximately 1–3% of all uterine neoplasms. Its biological behavior is characterized by hematogenous metastases and local recurrent growth including the pelvis and peritoneal cavity. In the management of US, surgery is the primary form of treatment. Up to now the role of adjuvant radiotherapy has not been clearly established. Patients and Methods: We report about 54 patients with US treated from 1954 to 1994 by surgical resection alone (22) or a combination of surgery and irradiation (32) and evaluate the influence of histology, stage and different treatment options on survival. Results and Conclusions: Our data indicate an increased disease-free survival for patients treated with adjuvant radiotherapy, especially if poor prognostic factors are present (advanced tumor stage, histopathological grade II or III of leiomyosarcoma and mixed mesodermal sarcoma). Postoperative irradiation using doses between 50 and 60 Gy is recommended, in selected cases brachytherapy should be added. Prospective multicentric trials including a statistically evaluable number of patients are necessary to further clarify the role of multimodality treatment programs for US.

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Autopsy findings in patients with uterine sarcoma

Cited by 53 publications

References 12 publications

Uteri̇n Karsi̇nosarkomlar: 18 Olguda Hi̇stopatoloji̇k Gözden Geçi̇rme

Uteri̇n Karsi̇nosarkomlar: 18 Olguda Hi̇stopatoloji̇k Gözden Geçi̇rme

Central Nervous System Involvement Secondary to Metastatic Mixed Müllerian Tumor of the Uterus

Radiotherapy in the Treatment of Uterine Sarcomas

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