Uterine carcinosarcoma with intestinal involvement: A case report and literature review

Laguna-Hernández,Pilar; Mendoza-Moreno,Fernando; Bru-Aparicio,Marta; Alvarado-Hurtado,Ricardo; Soto-Schütte,Sonia; Serrano-Yébenes,Eduardo; Allaoua-Moussaoui,Youssef; Mañes-Jiménez,Felix; Jiménez-Martín,Rubén; Jiménez-Alvarez,Laura; Córdova-Garcia,Diego; Diez-Alonso,Manuel  Mariano; Gutiérrez-Calvo,Alberto

doi:10.3892/mi.2023.75

Uterine carcinosarcoma with intestinal involvement: A case report and literature review

Authors:
- Pilar Laguna-Hernández
- Fernando Mendoza-Moreno
- Marta Bru-Aparicio
- Ricardo Alvarado-Hurtado
- Sonia Soto-Schütte
- Eduardo Serrano-Yébenes
- Youssef Allaoua-Moussaoui
- Felix Mañes-Jiménez
- Rubén Jiménez-Martín
- Laura Jiménez-Alvarez
- Diego Córdova-Garcia
- Manuel Mariano Diez-Alonso
- Alberto Gutiérrez-Calvo
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Affiliations: General Surgery Service, Príncipe de Asturias University Hospital, Alcalá de Henares, 28805 Madrid, Spain
Published online on: March 1, 2023 https://doi.org/10.3892/mi.2023.75
Article Number: 15
Copyright: © Laguna-Hernández et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Uterine carcinosarcoma (UCS) is a high‑grade endometrial cancer characterized by two components: Carcinomatous (epithelial) and sarcomatous (stromal tissue) elements. The present study describes a clinical case of this type of UCS and also provides a brief literature review of this type of tumor. A 72‑year‑old female visited the emergency department of the authors' hospital with pain in the hypogastric region, intestinal dysrhythmia since 3 months prior, fever and a palpable abdominal mass. Laboratory test results revealed sepsis and mild anemia and an imaging test revealed a large uterine tumor with wide areas of necrosis and adenopathies. As determined by the multidisciplinary committee, surgery was considered the main treatment option and this was performed with no incidences. Carcinosarcoma is a rare tumor, which most frequently occurs in older women. The diagnosis is based on symptoms and imaging tests, such as ecography and scans. The gold standard of treatment is surgery, although it is possible that other types of therapies, such as chemotherapy and radiotherapy may also be effective, depending on the tumor stage. On the whole, the prognosis of patients with this type of tumor is poor, with a low survival rate, even in earlier stages due to its malignant component and the possibility for metastasis. Surgery is the optimal treatment for this type of tumor, if this is possible, always individualizing patients.

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1	Matsuzaki S, Klar M, Matsuzaki S, Roman LD, Sood AK and Matsuo K: Uterine carcinosarcoma: Contemporary clinical summary, molecular updates, and future research opportunity. Gynecol Oncol. 160:586–601. 2021.PubMed/NCBI View Article : Google Scholar
2	Cantrell LA, Blank SV and Duska LR: Uterine carcinosarcoma: A review of the literature. Gynecol Oncol. 137:581–588. 2015.PubMed/NCBI View Article : Google Scholar
3	Soror NN, Woredekal D, Hemrock L, Gibson G and Bennett R: Uterine carcinosarcoma in a young female: Case report and literature review. Cureus. 13(e12642)2021.PubMed/NCBI View Article : Google Scholar
4	Denschlag D and Ulrich UA: Uterine carcinosarcomas-diagnosis and management. Oncol Res Treat. 41:675–679. 2018.PubMed/NCBI View Article : Google Scholar
5	Kord A, Rabiee B, Elbaz Younes I and Xie KL: Uterine carcinosarcoma: A case report and literature review. Case Rep Obstet Gynecol. 2020(8816348)2020.PubMed/NCBI View Article : Google Scholar
6	Pezzicoli G, Moscaritolo F, Silvestris E, Silvestris F, Cormio G, Porta C and D'Oronzo S: Uterine carcinosarcoma: An overview. Crit Rev Oncol Hematol. 163(103369)2021.PubMed/NCBI View Article : Google Scholar
7	Bužinskienė D, Mikėnas S, Drąsutienė G and Mongirdas M: Uterine sarcoma: A clinical case and a literature review. Acta Med Litu. 25:206–218. 2018.PubMed/NCBI View Article : Google Scholar
8	American Joint Committee on Cancer: Corpus uteri-carcinoma and carcinosarcoma. In: AJCC cancer staging manual. 8th edition. New York, NY: Springer, pp661-669, 2017.
9	Terblanche L and Botha MH: Uterine carcinosarcoma: A 10-year single institution experience. PLoS One. 17(e0271526)2022.PubMed/NCBI View Article : Google Scholar
10	Sagebiel TL, Bhosale PR, Patnana M, Faria SC and Devine CE: Uterine carcinosarcomas. Semin Ultrasound CT MR. 40:295–301. 2019.PubMed/NCBI View Article : Google Scholar
11	Elshaikh MA, Modh A, Jhingran A, Biagioli MC, Coleman RL, Gaffney DK, Harkenrider MM, Heskett K, Jolly S, Kidd E, et al: Executive summary of the American Radium Society^® appropriate use criteria for management of uterine carcinosarcoma. Gynecol Oncol. 158:460–466. 2020.PubMed/NCBI View Article : Google Scholar
12	Chiang CY, Huang HJ, Chang WY, Yang LY, Wu RC, Wang CC, Tung HJ, Chao A and Lai CH: Adjuvant therapy and prognosis in uterine carcinosarcoma. J Formos Med Assoc. 120:1977–1987. 2021.PubMed/NCBI View Article : Google Scholar
13	Toboni MD, Crane EK, Brown J, Shushkevich A, Chiang S, Slomovitz BM, Levine DA, Dowdy SC, Klopp A, Powell MA and Thaker PH: Uterine carcinosarcomas: From pathology to practice. Gynecol Oncol. 162:235–241. 2021.PubMed/NCBI View Article : Google Scholar
14	Almeida PC, Amaral Ferreira L and Donato P: Uterine carcinosarcoma with extensive extrauterine component. BMJ Case Rep. 14(e247643)2021.PubMed/NCBI View Article : Google Scholar
15	Crane E, Naumann W, Tait D, Higgins R, Herzog T and Brown J: Molecular variations in uterine carcinosarcomas identify therapeutic opportunities. Int J Gynecol Cancer. 30:480–484. 2020.PubMed/NCBI View Article : Google Scholar
16	Amant F, Dorfling CM, Dreyer L, Vergote I, Lindeque BG and Van Rensburg EJ: Microsatellite instability in uterine sarcomas. Int J Gynecol Cancer. 11:218–223. 2001.PubMed/NCBI View Article : Google Scholar
17	Taylor NP, Zighelboim I, Huettner PC, Powell MA, Gibb RK, Rader JS, Mutch DG, Edmonston TB and Goodfellow PJ: DNA mismatch repair and TP53 defects are early events in uterine carcinosarcoma tumorigenesis. Mod Pathol. 19:1333–1338. 2006.PubMed/NCBI View Article : Google Scholar
18	Kunc M, Gabrych A, Rękawiecki B, Gorczyński A, Haybaeck J, Biernat W and Czapiewski P: Immunohistochemical evaluation of mismatch repair proteins and p53 expression in extrauterine carcinosarcoma/sarcomatoid carcinoma. Contemp Oncol (Pozn). 24:1–4. 2020.PubMed/NCBI View Article : Google Scholar
19	Jenkins TM, Hanley KZ, Schwartz LE, Cantrell LA, Stoler MH and Mills AM: Mismatch repair deficiency in uterine carcinosarcoma: A multi-institution retrospective review. Am J Surg Pathol. 44:782–792. 2020.PubMed/NCBI View Article : Google Scholar
20	Jenkins TM, Cantrell LA, Stoler MH and Mills AM: PD-L1 and mismatch repair status in uterine carcinosarcomas. Int J Gynecol Pathol. 40:563–574. 2021.PubMed/NCBI View Article : Google Scholar