Abstract
Background. Osteosarcoma as a primary uterine tumor is extremely rare ; to our knowledge, only 22 cases have been reported to date. We report here a case of osteosarcoma originating from the uterus, and review the previous reports. Case. A 60-year-old woman, presented with lower abdominal pain. A diagnosis of uterine sarcoma was made, and the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. There was no apparent extrauterine extension of the tumor, although the serosal surface of the posterior uterine wall was involved by the tumor. Histologic examination of the surgical specimen showed that the tumor consisted of anaplastic-appearing spindle neoplastic cells with irregular nuclei, focal chondroid areas, and osteoclast-like multinucleated cells. No epithelial component was found in any section of the tumor.Immunohistochemically, any other mesenchymal components were not identified. The final pathological diagnosis was pure type of osteosarcoma originating from the uterine corpus. Postoperatively, the patient received pelvic radiation therapy and chemotherapy, consisting of carboplatin and docetaxel. Despite treatment, the patient developed multiple intra-abdominal nodules with local recurrence of the tumor 6 months following surgery. Conclusion. Neither epithelial nor any other mesenchymal components were identified by immunohistochemical evaluation. Histological features enabled to distinguish the pure type of heterologous sarcoma from carcinosarcoma and mixed sarcoma. There were no literature, including present case, which reported long term survives over five years of primary osteosarcoma originating from the uterine corpus.
