Obstet Gynecol Sci.  2015 May;58(3):251-255. 10.5468/ogs.2015.58.3.251.

Carcinosarcoma of the uterine cervix arising from Mullerian ducts

• Kim M
• Lee C
• Choi H
• Ko JK
• Kang G
• Chun KC

• KMID: 2148939
• DOI: http://doi.org/10.5468/ogs.2015.58.3.251

Abstract

Carcinosarcomas of the uterine cervix are extremely rare. Cervical carcinosarcoma can be characterized by having two different origins: the Mullerian 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 Mullerian 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.

Keyword

Breast neoplasms; Carcinosarcoma; Cervix uteri; Mullerian duct; Mullerian tumor mixed

MeSH Terms

Breast Neoplasms
Carcinosarcoma*
Cervix Uteri*
Diagnosis
Drug Therapy
Estrogens
Female
Humans
Hysterectomy
Lymph Node Excision
Middle Aged
Mullerian Ducts*
Recurrence
Sarcoma
Vimentin
Wolffian Ducts
Estrogens
Vimentin

Figure

• 

  Fig. 1 Magnetic resonance imaging. An 8-cm-sized round and well-defined mass in the uterine cervix.

• 

  Fig. 2 Immunohistochemical staining. (A) Positive for pancytokeratin in epithelial component (×40), (B) negative for CD 10 (×100), (C) negative for carletinin (×100), and (D) positive for esgrogen receptor (×100).

Reference

1. Arend R, Doneza JA, Wright JD. Uterine carcinosarcoma. Curr Opin Oncol. 2011; 23:531–536.

2. Meguro S, Yasuda M, Shimizu M, Kurosaki A, Fujiwara K. Mesonephric adenocarcinoma with a sarcomatous component, a notable subtype of cervical carcinosarcoma: a case report and review of the literature. Diagn Pathol. 2013; 8:74.

3. Clement PB, Young RH, Keh P, Ostor AG, Scully RE. Malignant mesonephric neoplasms of the uterine cervix. A report of eight cases, including four with a malignant spindle cell component. Am J Surg Pathol. 1995; 19:1158–1171.

4. Bague S, Rodriguez IM, Prat J. Malignant mesonephric tumors of the female genital tract: a clinicopathologic study of 9 cases. Am J Surg Pathol. 2004; 28:601–607.

5. Silver SA, Devouassoux-Shisheboran M, Mezzetti TP, Tavassoli FA. Mesonephric adenocarcinomas of the uterine cervix: a study of 11 cases with immunohistochemical findings. Am J Surg Pathol. 2001; 25:379–387.

6. Lopez-Chardi L, Gonzalez-Bosquet E, Rovira Zurriaga C, Lailla Vicens JM. Mesonephric carcinosarcoma of the uterine cervix: a case report. Eur J Gynaecol Oncol. 2013; 34:336–338.

7. Kang JS, Kim T, Lee HK, Lim NI, Park MH. Primary carcinosarcoma of the uterine cervix. Obstet Gynecol Sci. 1994; 37:1872–1879.

8. Sunwoo JG, Cho IS, Jeon S, Bae DH, Shin YW, Kim CJ, et al. A case of malignant mixed Müllerian Tumor (MMMT) of the uterine cervix. Obstet Gynecol Sci. 2008; 51:350–354.

9. Bansal S, Lewin SN, Burke WM, Deutsch I, Sun X, Herzog TJ, et al. Sarcoma of the cervix: natural history and outcomes. Gynecol Oncol. 2010; 118:134–138.

10. Clement PB, Zubovits JT, Young RH, Scully RE. Malignant mullerian mixed tumors of the uterine cervix: a report of nine cases of a neoplasm with morphology often different from its counterpart in the corpus. Int J Gynecol Pathol. 1998; 17:211–222.

11. Laterza R, Seveso A, Zefiro F, Formenti G, Mellana L, Donadello N, et al. Carcinosarcoma of the uterine cervix: case report and discussion. Gynecol Oncol. 2007; 107:S98–S100.

12. Kumar M, Bahl A, Sharma DN, Agarwal S, Halanaik D, Kumar R, et al. Sarcomatoid squamous cell carcinoma of uterine cervix: pathology, imaging, and treatment. J Cancer Res Ther. 2008; 4:39–41.

13. Kadota K, Haba R, Ishikawa M, Kushida Y, Katsuki N, Hayashi T, et al. Uterine cervical carcinosarcoma with heterologous mesenchymal component: a case report and review of the literature. Arch Gynecol Obstet. 2009; 280:839–843.