Uterine cervical carcinosarcoma with heterologous mesenchymal component: a case report and review of the literature

Kadota, Kyuichi; Haba, Reiji; Ishikawa, Masashi; Kushida, Yoshio; Katsuki, Naomi; Hayashi, Toshitetsu; Miyai, Yumi; Bando, Kenji; Shiota, Atsuko; Hata, Toshiyuki

doi:10.1007/s00404-009-1017-0

Cited by 19 publications

(10 citation statements)

References 14 publications

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“…Apart from the uterine corpus, CSs may develop in various organs, including the uterine cervix [24,25,26], ovary [27,28,29,30], fallopian tube [31], vagina [32,33], Douglas pouch [34] or even the peritoneum [35,36]. Uterine CS arising in a patient with uterus didelphys has been described [37] as well as a rare presentation of scalp metastasis from uterine CS [38].…”

Section: Introductionmentioning

confidence: 99%

Role of p53 Pathway Alterations in Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumors)

et al. 2014

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Carcinosarcomas (CSs; malignant mixed Müllerian tumors) of the uterus are highly malignant neoplasms characterized by an unfavorable outcome. They represent less than 5% of all uterine malignancies, and the median patient survival rate is only 21 months. p53 pathway alterations have been studied in CSs originating from the uterus, supporting the monoclonal nature of most but not all of these neoplasms. This paper gives an overview of the current knowledge of p53 pathway distortions in patients with uterine CSs. The survival of patients with uterine CSs in relation to p53 pathway alterations is also briefly summarized.

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Section: Introductionmentioning

confidence: 99%

Role of p53 Pathway Alterations in Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumors)

et al. 2014

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“…In the case reports reviewed, 24 patients ranging between 36 and 80 years of age were identified (6,10,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The treatment used in those cases were surgery followed by radiotherapy in 11 patients (6, 10, 11, 17, 20-22, 26, 27); surgery plus chemotherapy and radiotherapy in 6 cases (12,14,16,21,23); surgery plus chemotherapy in 2 cases (21,22); surgery alone in 3 cases (15,18,24); and radiotherapy in 2 cases (19,25). Kimyon Comert et al conducted a review of case series and case reports, rated as low quality by Amstar (only one database included, no removal of duplicate data, and no consideration of the risk of bias).…”

Section: Resultsmentioning

confidence: 99%

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

Garzón-Olivares

Cortés-Díaz

Angel‐Müller

et al. 2018

Rev. Colomb. Obstet. Ginecol.

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Objetivo: reportar el caso de una paciente con carcinosarcoma del cuello uterino con sangrado intraabdominal, y revisar la literatura disponible sobre el tratamiento y pronóstico de la entidad.Materiales y métodos: se reporta el caso de una paciente de 84 años, que consultó por masa abdominal y obstrucción del tracto urinario. Durante la estancia hospitalaria presentó sangrado intraabdominal con signos de choque, por lo que fue necesario realizar histerectomía abdominal total con salpingo-oforectomía bilateral, ligadura de hipogástricas y taponamiento de cavidad pélvica como intervenciones para controlar el sangrado. El estudio histológico reportó como diagnóstico carcinosarcoma del cérvix. La paciente evolucionó de forma adecuada y fue remitida para continuar manejo por oncología. Para la búsqueda de la literatura se realizó una pesquisa en las bases de datos Medline vía PubMed, SciELO y Ovid, utilizando los términos “uterinecarcinosarcoma” “treatment “cáncer treatment” “treatmentreview” y “treatmentoutcome”. La búsqueda se limitó por tipo de idioma, pero no por año de publicación.Resultados: 19 estudios cumplieron con los criterios de inclusión y de exclusión, estas fueron predominantemente reportes de caso. El estadio clínico reportado con mayor frecuencia fue FIGO IB en cerca del 53 % de los casos, y la presentación más frecuente fue el sangrado genital acompañado de masa pélvica. Con un seguimiento promedio de 15 meses, la sobrevida para este tumor es del 17 % para las pacientes que recibieron radioterapia. El 63 % de las pacientes que recibieron cirugía como tratamiento primario permanecieron libres de enfermedad durante los dos primeros años de seguimiento, con una frecuencia cercana al 100% para este mismo periodo cuando se administró radioterapia posterior a la cirugía.Conclusiones: el carcinosarcoma de cérvix es una entidad poco frecuente, cuya manifestación clínica más común suele ser la presencia de sangrado genital acompañado de masa pélvica. Dentro de las opciones terapéuticas disponibles para tratar esta entidad se encuentran la cirugía, la radio y la quimioterapia. No obstante, independientemente del tratamiento proporcionado, el pronóstico de sobrevida para las mujeres con esta patología es inferior al de las mujeres con carcinomas escamosos o adenocarcinomas. Se requieren estudios de alta calidad metodológica que evalúen la seguridad y la efectividad de las diferentes intervenciones para el abordaje terapéutico de esta entidad.

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“…Rather, the finding of high-risk HPV in both epithelial and mesenchymal components, suggests that initial HPV infection of the anal squamous mucosa occurred, which as the tumor grew, a subpopulation of tumor cells differentiated into a mesenchymal phenotype with retention of HPV infection. This has been the prevailing hypothesis for cases of cervical carcinosarcoma with HPV infection [9,13,14]. …”

Section: Discussionmentioning

confidence: 99%

A rare case of anal carcinosarcoma with human papilloma virus infection in both biphasic tumor elements: An immunohistochemical, molecular and ultrastructural study

Hickman

Bradshaw

Cassai

et al. 2016

Papillomavirus Research

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Carcinosarcoma of the anus is rare and has yet to be reportedly associated with the keratinocyte-specific Human Papilloma Virus (HPV). We describe a case of anal carcinosarcoma with HPV infection in both the epithelial and mesenchymal components of the tumor by immunohistochemistry, chromogenic in-situ hybridization (CISH) and further supported by electron microscopy (EM). Microscopic examination of the tumor showed nests of poorly-differentiated invasive squamous cell carcinoma with basaloid features intermixed with a hypercellular, atypical spindle cell proliferation. Immunohistochemistry demonstrated that the epithelial component was positive for AE1/AE3, p63, CK5/6 and p16, whilst the mesenchymal component was positive for smooth muscle actin, vimentin, and focally positive for desmin and p16, consistent with carcinosarcoma. The tumor was negative for GATA-3, CK7 and CK20. CISH demonstrated that the tumor was positive for high risk HPV (subtype 16/18) in both tumor components. EM further supported the presence of intracellular virus particles (~50 nm) that is compatible with HPV infection. Infection of both epithelial and mesenchymal tumor components by HPV has not been previously observed in the gastrointestinal tract. This finding may represent initial epithelial HPV infection with subsequent divergent tumoral differentiation and suggests the presence of viral replication in both biphasic tumor components.

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Uterine cervical carcinosarcoma with heterologous mesenchymal component: a case report and review of the literature

Abstract: We suppose that the similar proportion of p53 overexpression in both the epithelial and mesenchymal components may be one of the findings explaining the histogenesis of this tumor by combination theory.

Cited by 19 publications

References 14 publications

Role of p53 Pathway Alterations in Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumors)

Role of p53 Pathway Alterations in Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumors)

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

A rare case of anal carcinosarcoma with human papilloma virus infection in both biphasic tumor elements: An immunohistochemical, molecular and ultrastructural study

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