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Yuan H, Li L, Li N, Yao H. Sarcoma of the uterine cervix: experience of a single center. World J Surg Oncol 2024; 22:104. [PMID: 38637834 PMCID: PMC11025214 DOI: 10.1186/s12957-024-03376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/29/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVES To investigate the clinicopathological characteristics and prognosis of patients with primary sarcoma of the uterine cervix. METHODS We identified all patients with primary cervical sarcomas treated at our institution from 2002 to 2020 and analyzed the clinicopathological characteristics and prognosis. RESULTS 34 patients were identified, 7 (20.6%) patients had leiomyosarcoma, 6 (17.6%) had carcinosarcoma, 5 (14.7%) had Ewing sarcoma, 4 (11.8%) had rhabdomyosarcoma, 4 (11.8%) had undifferentiated sarcoma, 2 (5.9%) had adenosarcoma, 2 (5.9%) had endometrial stromal sarcoma, 1 (2.9%) had dermatofibrosarcoma protuberans, 1 (2.9%) had alveolar soft tissue sarcoma and 2 (5.9%) had sarcoma not otherwise specified. The median age of the whole patients was 43.5 years (range, 13-63). The median age of patients with Ewing sarcoma or rhabdomyosarcoma was 22 years (range, 13-39) and 17 years (range, 13-36 years), respectively. The distribution by stage was: stage I in 21 (61.8%) patients, stage II in 4 (11.8%), stage III in 6 (17.6%) and stage IV in 3 (8.8%). Overall, 30 patients (88.2%) received surgical treatment. The median follow-up was 33.3 months (range 3.6-187.3 months). 11 patients died within 2 years after diagnosis, most of them were patients with carcinosarcoma or undifferentiated sarcoma (45.5%, 5/11). In the entire cohort, 2- and 5-year OS were 67.2% and 56.9%, respectively. 5-year OS was 25.0% for undifferentiated sarcoma, 50.0% for rhabdomyosarcoma, 50.0% for carcinosarcoma, 53.3% for Ewing sarcoma, 57.1% for leiomyosarcoma. CONCLUSION Cervical sarcomas are rare neoplasms with multiple histological subtypes and follow an aggressive course. Prognosis may be associated with tumor histology and stage.
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Affiliation(s)
- Hua Yuan
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, China
| | - Lihong Li
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, China
| | - Ning Li
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, China
| | - Hongwen Yao
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, China.
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Cui T, Jin Y, Li B, Li J, Yue Y. Dynamic contrast-enhanced MR and PET/CT findings of uterine sarcomatoid carcinoma: a case report. BMC WOMENS HEALTH 2020; 20:223. [PMID: 33023546 PMCID: PMC7542461 DOI: 10.1186/s12905-020-01084-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 09/22/2020] [Indexed: 11/11/2022]
Abstract
Background Sarcomatoid carcinoma (SC) is a malignant tumour composed of spindle cells. The incidence of SC is low, especially in the uterus. The imaging features of uterine sarcomatoid carcinoma (USC) are rarely reported. We report a case of USC and discuss the dynamic contrast-enhanced MR (DCE-MR) and PET/CT findings. Case presentation A 69-year-old woman presented to the Department of Gynaecology with vaginal bleeding. Ultrasound examination discovered a heterogeneous mass in the cervix. Then, MRI examination of the pelvis was performed. On T2-weighted images, the uterus was replaced by an ill defined and diffuse lesion with inhomogeneous intensity. On T1-weighted images, the lesion appeared with signal hypointensity and was heterogeneously enhanced with contrast material. Additionally, enlarged lymph nodes were found in the pelvic cavity. PET/CT demonstrated high uptake in the region of the uterus and pelvic lymph nodes, which was consistent with MRI findings. The radiologists diagnosed the patient with malignant uterine lesions. The patient underwent hysterectomy and bilateral adnexectomy with pelvic lymph node dissection. Then, systemic radiotherapy and chemotherapy were performed. USC with lymph node metastasis was diagnosed with the help of immuno-histochemical analysis. There was no treatment related complication and no evidence of tumour recurrence at the postoperative 6-month follow-up. Conclusion MRI and PET/CT features are sufficient to indicate the malignant nature of a USC, but they are not pathognomonic.
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Affiliation(s)
- Tingting Cui
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yanfang Jin
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Bin Li
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jiyuan Li
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yunlong Yue
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
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Hrudka J, Rosová B, Halaška MJ. Squamous cell carcinoma with sarcomatoid differentiation or carcinosarcoma of the uterine cervix associated with HPV33 infection: report of a rare case. Diagn Pathol 2020; 15:12. [PMID: 32035484 PMCID: PMC7007670 DOI: 10.1186/s13000-020-00934-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/05/2020] [Indexed: 01/01/2023] Open
Abstract
Background Squamous cell carcinoma is the most common malignant tumor of the uterine cervix with a well-documented link to infection with human papillomaviruses (HPV). According to a recent classification, there are several morphological variants of cervical squamous carcinoma, without reference to sarcomatoid squamous cell carcinoma, which is well described in other organs. Case presentation In this paper, we describe an extremely rare case of a 77-year-old woman with primary malignant cervical tumor displaying biphasic histomorphology with an epithelioid and sarcomatoid part; the latter was immunohistochemistry positive for cytokeratin and vimentin. The association with a high-grade squamous intraepithelial lesion and molecular proof of HPV33 infection in the tumor tissue supported our diagnosis of carcinoma with partial sarcomatoid differentiation. Conclusion We report a rare case of a primary cervical epithelial tumor with a partial sarcomatoid phenotype, an unequivocal HPV infection, and an associated precancerous lesion in the cervical mucosa. This is the first description of an HPV33 infection underlying a biphasic epithelioid-sarcomatous tumor of the uterine cervix. The terminology overlap between sarcomatoid carcinoma and carcinosarcoma is also discussed.
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Affiliation(s)
- Jan Hrudka
- Department of Pathology, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Ruská 87, 100 00, Praha, 10, Prague, Czechia.
| | - Blanka Rosová
- Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czechia
| | - Michael J Halaška
- Department of Gynecology and Obstetrics, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czechia
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Metastatic Sarcomatoid Squamous Cell Carcinoma of the Cervix Presenting with Chest Mass. Case Rep Oncol Med 2017; 2017:5264564. [PMID: 29062577 PMCID: PMC5618741 DOI: 10.1155/2017/5264564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 07/26/2017] [Accepted: 08/16/2017] [Indexed: 01/18/2023] Open
Abstract
Background Sarcomatoid squamous cell carcinoma is a rare and aggressive form of cervical cancer. We report a case of metastatic sarcomatoid squamous cell carcinoma (SSCC) of cervix that presented with an anterior chest wall mass. Case A 43-year-old Hispanic female presented with a two-month history of a central chest wall mass. The patient's only past medical history was SSCC of the cervix, stage IIB, diagnosed two years priorly. She underwent neoadjuvant chemoradiation therapy (CRT) with cisplatin followed by radical hysterectomy. Surgical margins were positive which led to adjuvant CRT with carboplatin and paclitaxel. PET scan 4 months after the postoperative treatment was negative for recurrence and metastatic disease. On current presentation, the CT chest revealed anterior mediastinal destructive soft tissue mass involving sternum, and the biopsy showed SSCC. The patient received palliative radiation therapy to her chest with improvement in pain and ability to swallow. After discussing the prognosis she refused further chemotherapy and decided on hospice care. Conclusion Despite good response to first-line therapy, SSCC tends to recur early and does not respond to second-line therapy. Radiation therapy seems to be the most effective modality for treatment, but randomized controlled trials of therapy are impractical.
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Liu TW, Hung SH, Chen PY. Sinonasal spindle cell carcinoma presenting with bilateral visual loss: A case report and review of the literature. Oncol Lett 2016; 12:401-404. [PMID: 27347158 PMCID: PMC4906660 DOI: 10.3892/ol.2016.4620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/18/2016] [Indexed: 11/05/2022] Open
Abstract
Spindle cell carcinoma (SpCC) is a rare variant of squamous cell carcinoma (SCC). SpCC of sinonasal origin is relatively rare and more aggressive than normal SCC. It most commonly involves the maxillary sinus, and rarely the sphenoid sinus. The present study reports a case of sphenoid sinus SpCC presenting with bilateral visual loss. Following endoscopic sinus decompression surgery, the patient was referred to the Oncology Department for a staging workup, and subsequently received concurrent chemoradiotherapy; however, the vision of the patient was not recovered, despite treatment. To the best of our knowledge, this is the first reported case of synchronous inverted papilloma of the sphenoid sinus and SpCC presenting with optic nerve compression.
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Affiliation(s)
- Tsung-Wei Liu
- Department of Otolaryngology - Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei 110, Taiwan, R.O.C.; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Po-Yueh Chen
- Department of Otolaryngology - Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei 110, Taiwan, R.O.C.; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
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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.
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Shrivastava S, Barmon D, Deka P, Ch Kataki A, Choudhary BK. Sarcomatoid carcinoma of the cervix with foci of malignant melanoma. J Midlife Health 2014; 5:41-4. [PMID: 24672206 PMCID: PMC3955046 DOI: 10.4103/0976-7800.127792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy of the cervix. Until date around eighteen cases of SSCC have been reported in the literature. It is an aggressive tumor with poor prognosis. The tumor usually presents at an advanced stage. Similarly, primary melanomas of the uterine cervix are rare tumors with not more than 60 cases reported in the world literature. It also has a poor prognosis. There is no reported case of sarcomatoid carcinoma with malignant melanoma. Here, we are presenting a rare case of cervical carcinoma with histopathology suggestive of SSCC with foci of malignant melanoma proven by immunohistochemistry study. Case Report: The present case report is about a 42-year-old, Mrs. SR, P5 L3 D1 A1 , presented with the complaints of intermittent bleeding per vaginum since last 3 years and severe pain in the right lower limb since 1 month. On examination, there was a proliferative growth in the cervix. Her magnetic resonance imaging (MRI) showed cervical mass lesion with right parametrial extension invading the right ureter and bladder wall causing hydroureteronephrosis with contiguous bilateral pelvic nodes. There were multiple lesions in the left femur. Diagnosis of carcinoma of cervix International Federation of Gynecology and Obstetrics stage IIIB with distant metastasis was made. Histopathology report was suggestive of sarcomatoid carcinoma with foci of melanocytic melanoma. She was planned to be treated with palliative radiation. Discussion: About 90% of cervical carcinomas are squamous cell carcinoma. Adenocarcinoma constitute about 3-4% of all cervical carcinomas. Other rare pathologies are lymphoma, melanoma, sarcoma and metastatic tumors. Our case is a rare combination of sarcomatoid carcinoma with foci of malignant melanoma of cervix.
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Affiliation(s)
- Sushruta Shrivastava
- Department of Gynaecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
| | - Debabrata Barmon
- Department of Gynaecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
| | - Pankaj Deka
- Department of Gynaecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
| | - Amal Ch Kataki
- Department of Gynaecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
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Abstract
Sarcomatoid carcinoma is a rare pathological entity of the cervix. A case of FIGO stage III sarcomatoid carcinoma of the cervix is reported. The patient was treated with concurrent radiotherapy and chemotherapy. Despite the initial excellent local response to therapy, she developed an early metastatic disease. In a review of the published studies, only 19 cases were reported on this type of cervical cancer.
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Affiliation(s)
- Tahani H Nageeti
- Department of Oncology, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia.
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