1
|
Zhu R, Zhao S, Song D, Zou C. A case of cervical sarcoma and literature review. Asian J Surg 2023; 46:4703-4704. [PMID: 37596210 DOI: 10.1016/j.asjsur.2023.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/16/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- Ruisen Zhu
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, 266000, China
| | - Shuping Zhao
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, 266000, China
| | - Dongdong Song
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, 266000, China
| | - Cunhua Zou
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, 266000, China.
| |
Collapse
|
2
|
Marchocki Z, Swift B, Covens A. Small Cell and Other Rare Histologic Types of Cervical Cancer. Curr Oncol Rep 2022; 24:1531-1539. [PMID: 35947285 DOI: 10.1007/s11912-022-01316-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The goal of this paper was to summarize the recent evidence on rare subtypes of cervical cancer including small-cell carcinoma of the cervix (SCCC), gastric-type adenocarcinoma, and carcinosarcoma. RECENT FINDINGS All three cervical cancer subtypes are aggressive with poor treatment response and high recurrence rates. Molecular studies have identified various actionable mutations in both SCCC (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN). While there are a limited number of case reports demonstrating a favorable response for recurrent SCCC to immune checkpoint inhibitors, a larger case series failed to show benefit. The checkpoint inhibitors role in gastric-type adenocarcinoma and carcinosarcoma is yet to be determined. Ninety-one percent of SCCC cases show PARP expression, suggesting a possible role for PARP inhibitors; however, this has yet to be examined in future clinical trials. More studies are needed, with a focus on targeted therapies. The role of PARP inhibitors in SCCC is potentially promising, but significant collaboration between centers/groups will be required to achieve this.
Collapse
Affiliation(s)
- Zibi Marchocki
- Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada
| | - Brenna Swift
- Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada
| | - Allan Covens
- Division of Gynecologic Oncology, Sunnybrook, Health Sciences Centre, Odette Cancer Centre, Toronto, ON, Canada.
| |
Collapse
|
3
|
Shu X, Zhou Y, Wei G, Chen X, Qiu M. Cervical Carcinosarcoma: Current Understanding on Pathogenesis, Diagnosis, Management and Future Perspectives. Clin Med Insights Oncol 2022; 15:11795549211056273. [PMID: 35153524 PMCID: PMC8826264 DOI: 10.1177/11795549211056273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/10/2021] [Indexed: 02/05/2023] Open
Abstract
Cervical carcinosarcoma (CCS) is a rare aggressive tumor which was referred to as
a sarcoma initially with its morbidity less than 1% of all cervical cancers.
Four theories have been proposed for the pathogenesis of CCS. The “metaplastic
theory,” also called “monoclonal theory,” has been widely accepted so far. The
most common clinical symptom of CCS is abnormal vaginal bleeding. CCS is much
less common than the counterparts in uterine corpus and usually confused with
uterine carcinosarcoma (UCS) or common cervical cancer. The management for CCS
has been mainly extrapolated from studies of UCS or cervical cancers. However,
CCS has its special anatomical position and biological behaviors and is usually
diagnosed at an early stage than UCS. Currently, there is no consensus on the
survival, management and prognosis factors of CCS. We reviewed and summarized
the literatures regarding to the epidemiology, clinical presentations,
pathogenesis, diagnosis and treatment of CCS for providing clinicians with
comprehensive information to diagnose and treat this malignancy.
Collapse
Affiliation(s)
- Xinyao Shu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuwen Zhou
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Guixia Wei
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaorong Chen
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Qiu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Hsu LC, Chiang AJ. Triple synchronous malignancies of the female genital tract with an advanced stage carcinosarcoma of the uterine cervix: A case report. Taiwan J Obstet Gynecol 2021; 59:613-614. [PMID: 32653141 DOI: 10.1016/j.tjog.2020.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Li-Chuan Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| | - An-Jen Chiang
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| |
Collapse
|
5
|
Ribeiro B, Silva R, Dias R, Patrício V. Carcinosarcoma of the uterine cervix: a rare pathological finding originating from mesonephric remnants. BMJ Case Rep 2019; 12:12/3/e227050. [PMID: 30936330 DOI: 10.1136/bcr-2018-227050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Carcinosarcoma of the uterine cervix is a very rare tumour that has been described in less than 70 cases in the literature. It is less common compared with carcinosarcoma of the uterine corpus and it can have two origins: the Müllerian ducts and the mesonephric duct remnants. The association of mesonephric carcinoma with a sarcomatous component was reported in only 11 cases, including the following. We describe a case of a 64-year-old woman, presenting with vaginal bleeding and a cervical lesion reported as a sarcoma of endometrial stroma in the first biopsy. After exclusion of distant disease, she was submitted to radical surgery and the final histopathological examination showed a carcinosarcoma of the cervix with mesonephric origin.
Collapse
Affiliation(s)
- Bárbara Ribeiro
- Gynecology and Obstetrics Department, Hospital de Braga, Braga, Portugal
| | - Raquel Silva
- Pathology, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Renata Dias
- Pathology, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Vanda Patrício
- Gynecology Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| |
Collapse
|
6
|
Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma: Meta-analysis of Extremely Rare Tumor of Cervix. Int J Gynecol Cancer 2017; 27:1957-1969. [DOI: 10.1097/igc.0000000000001086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectiveThe aim of this study was to evaluate the prognostic factors, treatment options, and survival outcomes of primary carcinosarcomas of the uterine cervix.MethodsAn electronic search of the literature was conducted from 1951 to February 2017 to identify articles on primary cervical carcinosarcoma. After comprehensive evaluation of case series and case reports, 81 cases were included in the study.ResultsThe most common clinical FIGO (International Federation of Gynecology and Obstetrics) stage was IB at 53% of cases. Median follow-up time was 15 months (range, 1.75–156 months). Two-year disease-free survival (DFS) and overall survival (OS) of the entire cohort were 49% and 60%, respectively. Both 2-year DFS and OS were significantly higher in patients with stage I than in those with stage II disease or greater (73% vs 22%, P = 0.000 and 82% vs 33%, P = 0.000, respectively). Two-year OS was 17% for patients who received primary radiotherapy, whereas it was 68% for those who underwent only surgery (P = 0.003). Surgery followed by adjuvant radiotherapy with or without chemotherapy was significantly associated with improved DFS and OS compared with primary radiotherapy. Two-year DFS was 63% in patients who underwent primary surgery, whereas it was 100% in patients treated with primary surgery followed by adjuvant radiotherapy with chemotherapy (P = 0.030). Stage alone was an independent prognostic factor for risk of both recurrence and death (hazard ratios, 9.8 [P = 0.004] and 14 [P = 0.018], respectively).ConclusionsIn due course of presentation, the tumor stage has a great importance because it is the only independent factor for prognosis. Surgery followed by adjuvant radiotherapy with or without chemotherapy seems to be related with better OS and DFS.
Collapse
|
7
|
Guerrero J, Aftandilians T, Cracchiolo B, Heller DS. Primary Carcinosarcoma of the Uterine Cervix: Report of a Case and Review of the Literature. J Gynecol Surg 2016. [DOI: 10.1089/gyn.2016.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jessenia Guerrero
- Department of Pathology and Laboratory Medicine, Rutgers–New Jersey Medical School, Newark, NJ
| | - Tania Aftandilians
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers–New Jersey Medical School, Newark, NJ
| | - Bernadette Cracchiolo
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers–New Jersey Medical School, Newark, NJ
| | - Debra S. Heller
- Department of Pathology and Laboratory Medicine, Rutgers–New Jersey Medical School, Newark, NJ
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers–New Jersey Medical School, Newark, NJ
| |
Collapse
|
8
|
Carcinosarcoma of the uterine cervix arising from Müllerian ducts. Obstet Gynecol Sci 2015; 58:251-5. [PMID: 26023676 PMCID: PMC4444523 DOI: 10.5468/ogs.2015.58.3.251] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/12/2014] [Accepted: 10/12/2014] [Indexed: 11/08/2022] Open
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.
Collapse
|
9
|
|
10
|
Semczuk A, Ignatov A, Obrzut B, Reventos J, Rechberger T. Role of p53 Pathway Alterations in Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumors). Oncology 2014; 87:193-204. [DOI: 10.1159/000363574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 05/07/2014] [Indexed: 01/10/2023]
|
11
|
Shiga N, Toyoshima M, Akahira JI, Nagase S, Niikura H, Yaegashi N. Carcinosarcoma of the uterine cervix with a clear cell adenocarcinoma component. Int Cancer Conf J 2013. [DOI: 10.1007/s13691-012-0080-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
12
|
Intramural Metastases of Rectum From Carcinosarcoma (Malignant Müllerian Mixed Tumor) of Uterine Cervix. Clin Nucl Med 2013; 38:137-9. [DOI: 10.1097/rlu.0b013e318266d4bd] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
13
|
López-Olmos J, Navarro P, Montoliu G, López-Puchau E. Carcinosarcoma de cérvix asociado a teratoma quístico maduro de ovario. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2010. [DOI: 10.1016/j.gine.2009.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
14
|
High expressions of bcl-2 and survivin, and decreased apoptosis in uterine cervical carcinosarcoma compared to cervical squamous cell carcinoma. Arch Gynecol Obstet 2010; 284:175-81. [DOI: 10.1007/s00404-010-1610-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 07/14/2010] [Indexed: 10/19/2022]
|
15
|
Kuyumcuoğlu U, Kale A. Homologous type of malignant mixed Mullerian tumor of the uterus presenting as a cervical mass. J Chin Med Assoc 2009; 72:533-5. [PMID: 19837648 DOI: 10.1016/s1726-4901(09)70423-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Malignant mixed Mullerian tumors are composed of a mixture of sarcoma and carcinoma. The carcinomatous element is usually glandular, whereas the sarcomatous element may resemble normal endometrial stroma (homologous or so-called carcinosarcoma). Here, we present a homologous type of malignant mixed Mullerian tumor of the uterus that presented as a cervical mass. We describe a 55-year-old patient who had a cervical mass arising from the uterus. We performed total abdominal hysterectomy and bilateral salpingo-oophorectomy and surgical staging (including (peritoneal washings, suspicious areas or peritoneal surfaces sampled, infracolic omental sampling, pelvic and paraaortic lymph node sampling, and appendectomy). Carcinosarcomas of the uterine cervix are extremely rare, and when a postmenopausal woman with a cervical mass is admitted to the gynecology clinic, the physician should keep in mind that the mass might be a carcinosarcoma.
Collapse
Affiliation(s)
- Umur Kuyumcuoğlu
- Department of Obstetrics and Gynecology, Dicle University Medical School, Diyarbakir, Turkey
| | | |
Collapse
|
16
|
Kadota K, Haba R, Ishikawa M, Kushida Y, Katsuki N, Hayashi T, Miyai Y, Bando K, Shiota A, Hata T. Uterine cervical carcinosarcoma with heterologous mesenchymal component: a case report and review of the literature. Arch Gynecol Obstet 2009; 280:839-43. [DOI: 10.1007/s00404-009-1017-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Accepted: 02/17/2009] [Indexed: 11/25/2022]
|