A case of uterine cervical carcinosarcoma with good prognosis

Abstract

 Carcinosarcoma of the uterine cervix is rare and generally regarded as a very aggressive tumor with a poor prognosis.However, there could be very unusual reported cases in which cervical carcinosarcoma has a good prognosis. We present a case of cervical carcinosarcoma with invasion of the endometrium and fallopian tubes in a patient who is alive with no recurrence more than 3 years after the initial surgery. A 61-year-old nulligravida with post-menopausal genital bleeding visited our outpatient clinic. Transvaginal sonography and magnetic resonance imaging revealed an endometrial tumor and adnexal cysts with solid components on either side of the uterus. Endometrial malignancy was diagnosed, and she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and adjuvant chemotherapy with cisplatin and ifosfamide for 6 months. Gross examination of the surgically resected specimen revealed it to be a polypoid and bulky tumor (5 × 4.5 cm) arising from the endocervix. Apart from this, a polypoid sessile tumor adhering to the endometrium and both tubal lumina was detected. Histologically, the tumor had arisen exophytically from the endocervix;it had adenocarcinomatous and chondrosarcomatous components. Malignant epithelial tumors resembling the epithelial component of the endocervical tumor were also detected in the endometrium and fallopian tubes. Despite the predicted poor prognosis, the patient is currently alive and free of disease more than 36 months after the initial surgery. It is likely that the biological behavior and prognosis of these tumors are different than those expected. Therefore, cervical carcinosarcoma may show better prognosis than endometrial carcinosarcoma.