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Gauci M, Calleja-Agius J. Spotlight on Carcinosarcoma of the Ovary: A Scoping Review. ACTA MEDICA (HRADEC KRALOVE) 2024; 67:1-11. [PMID: 39288440 DOI: 10.14712/18059694.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Ovarian carcinosarcoma, also referred as malignant mixed Mullerian tumour, is an uncommon, highly aggressive and malignant neoplasm which makes up 1 to 4% of all ovarian tumours. It is biphasic involving both malignant sarcomatous (mesenchymal) and carcinomatous (epithelial) cells. There are various subtypes such as serous and endometrioid. However, the mesenchymal part is sarcomatous. About 90% of cases of ovarian carcinosarcoma spread outside the ovary. The two most accepted theories of origin for carcinosarcoma of the ovary are the collision and conversion theories. A third theory is the combination theory. Prognosis remains poor even when still localised in the ovary. In the last few years, there has been no change in the survival rate. The median survival rate is lower than 2 years. Clinical features mainly include lower abdominal pain and a palpable abdominal mass. Ovarian carcinosarcoma remains poorly understood and understudied. Being a rare tumour, elaborate therapeutic consensus is not available for ovarian carcinosarcoma. The main treatment involves cytoreductive surgery and then chemotherapy. The type of chemotherapy, role of radiotherapy and novel therapies need to be further studied. The main objective of this article is to review the current literature on carcinosarcoma of the ovary.
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Affiliation(s)
- Martina Gauci
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Malta.
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Malta
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Kozłowski M, Nowak K, Kordek A, Cymbaluk-Płoska A. Therapeutic Management of Rare Primary Ovarian Neoplasms: Carcinosarcoma, Leiomyosarcoma, Melanoma and Carcinoid. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7819. [PMID: 34360112 PMCID: PMC8345663 DOI: 10.3390/ijerph18157819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/15/2022]
Abstract
Carcinosarcoma, leiomyosarcoma, melanoma and carcinoid as primary tumors in the ovary are extremely rare. In this paper, the authors reviewed the literature from 2010 to 2021, based on specific criteria, to analyze the treatment of these rare ovarian neoplasms. We also aimed to verify whether modern therapies have been found in recent years. For this article, 80 papers were finally selected. The vast majority of the articles were clinical case reports. Despite single mentions of new potential pharmacological treatments, surgery (radical or fertility-sparing) is definitely the mainstay of treatment. There are currently no treatment guidelines for these tumors. A review of the literature has revealed the use of various adjuvant treatments. We, therefore, believe that a more detailed understanding of the biology of these tumors is necessary in order to find new target points for treatment. We would like to emphasize the importance of creating an international database of rare ovarian tumors which would make it possible to gather data from various oncological centers and enable further research into these neoplasms.
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Affiliation(s)
- Mateusz Kozłowski
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (K.N.); (A.C.-P.)
| | - Katarzyna Nowak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (K.N.); (A.C.-P.)
| | - Agnieszka Kordek
- Department of Neonatal Diseases, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (K.N.); (A.C.-P.)
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Kostov S, Kornovski Y, Ivanova Y, Dzhenkov D, Stoyanov G, Stoilov S, Slavchev S, Trendafilova E, Yordanov A. Ovarian Carcinosarcoma with Retroperitoneal Para-Aortic Lymph Node Dissemination Followed by an Unusual Postoperative Complication: A Case Report with a Brief Literature Review. Diagnostics (Basel) 2020; 10:E1073. [PMID: 33322259 PMCID: PMC7763638 DOI: 10.3390/diagnostics10121073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023] Open
Abstract
Introduction. Ovarian carcinosarcoma (OCS), also known as malignant mixed Müllerian tumour (MMMT), is one of the rarest histological subtypes of ovarian cancer. It is an aggressive tumour with a dismal prognosis-the median survival of patients is less than two years. The rarity of the disease generates many controversies about histogenesis, prognostic factors and treatment of OCS. Histologically, OCS is composed of an epithelial and sarcomatous component. Case report. In the present case, a patient with bilateral ovarian cysts and bulky paraaortic lymph nodes is reported. Retroperitoneal paraaortic lymph node metastases were the only extrapelvic dissemination of OCS. The patient underwent comprehensive surgical staging procedures, including total abdominal hysterectomy and bilateral salpingo-oophorectomy, supracolic omentectomy and selective para-aortic lymphadenectomy. Histologically the ovarian carcinosarcoma was composed of an epithelial component (high-grade serous adenocarcinoma) and three sarcomatous components (homologous-endometrial stromal cell sarcoma, and heterologous-chondrosarcoma, rhabdomyosarcoma). Immunohistochemistry staining was performed. A postoperative complication (adhesion between the abdominal aorta and terminal ileum causing obstructive ileus) that has never been reported in the medical literature occurred. Conclusion. Carcinosarcomas are carcinomas with epithelial-mesenchymal transition and heterologous differentiation. Retroperitoneal pelvic and paraaortic lymph nodes should be carefully inspected in patients with ovarian tumours. Adhesions between the small bowels and abdominal aorta are possible complications after lymph node dissection in the paraaortic region.
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Affiliation(s)
- Stoyan Kostov
- Department of Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (S.K.); (S.S.)
| | - Yavor Kornovski
- Department of Obstetrics and Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (Y.K.); (Y.I.); (S.S.); (E.T.)
| | - Yonka Ivanova
- Department of Obstetrics and Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (Y.K.); (Y.I.); (S.S.); (E.T.)
| | - Deyan Dzhenkov
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (D.D.); (G.S.)
| | - George Stoyanov
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (D.D.); (G.S.)
| | - Stanislav Stoilov
- Department of Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (S.K.); (S.S.)
| | - Stanislav Slavchev
- Department of Obstetrics and Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (Y.K.); (Y.I.); (S.S.); (E.T.)
| | - Ekaterina Trendafilova
- Department of Obstetrics and Gynecology, Medical University of Varna “Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria; (Y.K.); (Y.I.); (S.S.); (E.T.)
| | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria
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