Carcinosarcoma of the uterine cervix arising from Müllerian ducts

Abstract

Carcinosarcomas of the uterine cervix are extremely rare. Cervical carcinosarcoma can be characterized by having two different origins: the Müllerian ducts and the mesonephric duct remnants. A 53-year-old Korean woman was admitted to the hospital because of pelvic mass detected on computed tomography scan done at private clinic. A Radical hysterectomy with bilateral salpingooophorectomy and pelvic lymphadenectomy was carried out upon a diagnosis of stage IB2 cervical sarcoma. Immunohistochemically, the epithelial component was positive for pancytokeratin and estrogen receptor, but negative for CD 10 and carletinin. The mesenchymal component was positive for vimentin. The histopathologic diagnosis was a carcinosarcoma of the uterine cervix arising from Müllerian ducts. She underwent chemotherapy. She developed systemic recurrence seven months after operation and died of disease. The origin of cervical carcinosarcoma needs to be verified and immunohistochemical studies using mesonephric marker (CD 10, carletinin, and estrogen receptor) is helpful.

Carcinosarcoma of the uterine cervix: a rare pathological finding originating from mesonephric remnants

“…At least 42 cases of mesonephric carcinomas have been described, corresponding to 16% of cervical carcinosarcomas, and a sarcomatous component was present in 11 cases (table 1), including the case we describe 5. The most common presentation in the literature is abnormal vaginal bleeding and most occur in postmenopausal women 6 7…”

“…These neoplasms are often accompanied by a sarcomatous component, namely when there is a mesenchymal part along with the epithelial component: this is the case in 10 of the cases found in literature 5. The presence of a sarcomatous component associated with carcinomatous component has been explained by several theories but the most accepted is that carcinosarcomas are dedifferentiated (metaplastic) carcinomas with both elements, carcinomatous and sarcomatous 7 8. In immunohistochemical studies there are positivity for both cytokeratin (present in the carcinomatous element) and vimentin (positive in the mesenchymal component) 2 5 9.…”

Exceptional Response of Cryoablation Followed by Pembrolizumab in a Patient with Metastatic Cervical Carcinosarcoma with High Tumor Mutational Burden: A Case Report

“…They occur relatively commonly in the corpus of the uterus but are extremely rare in the cervix, constituting less than 1% of all cervical malignancies . Approximately only 80 cases have been reported in the English literature so far , and 128 cases have been documented according to the National Cancer Institute's Surveillance, Epidemiology, and End Results database . Owing to their rarity, cervical carcinosarcomas have not been well characterized, and currently there is no standard of care for this disease .…”

Carcinosarcoma del cuello uterino: reporte de caso y revisión de la literatura

“…At present, carcinosarcoma (CS) is considered by the World Health Organisation (WHO) as a mixed tumour with an epithelial histologic component (carcinomatous) and a mesenchymal component (sarcomatous), although at first it was considered a sarcoma (1). Carcinosarcomas mostly arise in the corpus of the uterus, less frequently in the ovaries, and exceptionally in the cervix (2,3). Preliminary studies suggest that this neoplasm is a subtype of metaplastic carcinoma, based on biological behaviour, lymph node spread pattern and clonality testing (4).…”

“…Preliminary studies suggest that this neoplasm is a subtype of metaplastic carcinoma, based on biological behaviour, lymph node spread pattern and clonality testing (4). It has been proposed that, when located in the cervix, these tumouts should be classified, according to their origin, as malignant mixed mesonephric tumours or malignant mixed Müllerian tumours (2). Therefore, cervical carcinosarcoma is considered to be a different entity from carcinosarcoma of the uterine corpus.…”