Uterine Carcinosarcoma: A Case Report and Literature Review

Abstract

Uterine carcinosarcomas are rare and extremely aggressive undifferentiated carcinomas which include both carcinomatous and sarcomatous elements. A 52-year-old female presented with heavy irregular menstrual bleeding for several years and new right elbow pain and swelling. Ultrasound and computed tomography showed a large uterine mass with regional and distant metastatic lymphadenopathy and suspicious findings of osseous metastasis to the right elbow. A biopsy confirmed uterine carcinosarcoma, and the patient underwent chemotherapy and then surgical resection of the uterine mass with palliative radiotherapy of the right elbow. The postoperative imaging showed new metastasis, and the patient was scheduled to start on immunotherapy. Considering the highly invasive nature of uterine carcinosarcomas, timely detection of this cancer using characteristic imaging and pathology findings is of extreme importance to improve the patient’s survival.

Uterine carcinosarcoma with intestinal involvement: A case report and literature review

“…the stages of carcinosarcomas are similar to those of the endometrial carcinoma system (5). the stages of stages of UCS table I. risk factors of uterine carcinosarcoma.…”

“…As patients frequently exhibit an extra-uterine pathology, Ct scan is recommended for classification and/or magnetic resonance (MR) imaging prior to surgery (2). However, a Ct scan is more effective than Mr imaging for adenopathies (5). Positron emission tomography is more sensitive (68 vs. 50%), but less specific (88 vs. 93%) than MR imaging to detect adenopathies (7).…”

“…It may present as a pelvic mass shown on an imaging test or as a prolapsed cervix (2). Due to this malignancy, the extrinsic compression of the bladder or intestines may occur, leading to urinary retention, bowel obstruction, constipation and tenesmus (5). approximately 10% of patients exhibit metastasis at the time of diagnosis (4) and 30-40% are positive for adenopathies (6).…”

“…Sentinel node efficacy for this tumor is not yet well known (1), and hormonotherapy is not common treatment (6). there are currently studies available on treatment with tyrosine kinase inhibitors, Her2 and immune checkpoint inhibitors (5). Immunotherapies may hold promising outcomes for patients with tumors positive for mismatch repair (MMR) deficiency (MMR-D) and programmed cell death ligand-1 (PD-l1) (6).…”

A Surprising Diagnosis in a Breast Lump: The First Case Report of Uterine Carcinosarcoma Presenting as Breast – Only Metastasis

“…Uterine carcinosarcoma (UCS) is a rare and invasive un-differentiated neoplasm that constitutes both an epithelial and a stromal component (sarcoma) arising from a single malignant epithelial clone. it represents less than 5% of all uterine tumors but accounts for 15% of all deaths caused by uterine malignancy [11]. the prognosis of UCS is often very poor, with 30-40% of cases having extrauterine involvement at the time of presentation, include regional lymph nodes, ovaries, fallopian tubes, and omentum, and over 10% of patients already developed distant metastasis [12].…”