A case report of Carcinosarcoma�Rare type of uterine sarcoma

Dr Pallabi Deka; Dr Amrutha Bhandary; Dr Kavitha D’souza; Dr Pradnya Shetty

Volume : VI, Issue : XII, December - 2016

A case report of Carcinosarcoma�Rare type of uterine sarcoma

Dr Pallabi Deka, Dr Amrutha Bhandary, Dr Kavitha D Souza, Dr Pradnya Shetty

Abstract :

INTRODUCTION:Carcinosarcoma also known as malignant mixed mullerian tumor. It is uncommon and its incidence is< 5% of all uterine malignancies. It is associated with more than 15 % cancer related deaths. Almost all these cancers occur after menopause with median age of 62 years. The survival of women with advanced uterine carcinosarcoma is poor with a pattern of failure indicating greater likelihood of upper abdominal and distant metastatic recurrence. CASE SUMMARY: A 60 year old female came with complaints of bleeding per vagina associated with history of weight loss. She attained menopause 6 years back. On examination umbilicus was central,inverted. A 2cm infraumbilical scar was noted, no dilated veins or sinuses were seen. On speculum examination–cervix and vaginal mucosa were healthy, minimal blood tinged discharge was seen . Per vaginal examination revealed–uterus was around 8 to 10wks size, anteverted , mobile, no fornicial mass or tenderness.PV findings was correlated with per rectal examination and rectal mucosa was free. MRI was done,which showed a 8*6 cm growth within the uterine cavity with evidence of infiltration of the myometrium extending upto serosal surface in the right anterior wall .However no evidence of serosal involvement was seen. B/L fallopian tubes were dilated with multiple enlarged paraarotic lymph nodes. Fractional curettage with cervical biopsy was done and provisional diagnosis of carcinosarcoma was made based on histopathology report. Total abdominal hysterectomy with bilateral pelvic lymphadenectomy done .Final histopatholgy report revealed carcinosarcoma. CONCLUSION: Total abdominal hysterectomy with bilateral salpingo–oophorectomy along with pelvic node dissection is the mainstay if the treatment of carcinosarcoma. Stage1A1 –surgery+tumour directed RT or CT .Stage1A2 to stage 4 with adequate debulking– CT with tumour directed RT or whole abdomen RT