Abstract
Background : We report on a rare case of carcinosarcoma of the uterus with neuroectodermal differentiation.
Case : A 59-year-old woman presented with vaginal bleeding. On pelvic examination, the uterus was enlarged to newborn head size. Preoperative endometrial cytology was performed. Cytological findings revealed giant, bizarre or round tumor cells and papillary clusters or keratinizing cells were found isolated or in small clusters or groups in a background of necrosis. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, para-aortic lymphadenectomy and omentectomy. On histological analysis the tumor was comprised of carcinosarcoma containing both components of adenocarcinoma and sarcoma. In the tumor, immature components of the central nervous system were found such as primitive neural tubules, fat, bone, cartilage, and squamous epithelium. On immunohistochemical analysis tumor cells were positive for glial fibrillary acidic protein, S-100 protein and neuron-specific enolase.
Conclusion : Although preoperative diagnosis of uterine carcinosarcoma is difficult, cytological and immunohistochemical findings are useful in diagnosing carcinosarcoma with neuroectodermal differentiation.
