Carcinosarcoma of the uterus

Changed by Matthew Lukies, 24 Aug 2017

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Malignant mixed Mullerian tumour (MMMT) of the uterus, also known a uterine carcinosarcoma, is the commonest (up to 50%) uterine sarcomassarcoma. They are thought to account for 2-8% of all malignant uterine cancers 1-2. The uterus is the commonest site for malignant mixed Mullerian tumours 1

Pathology

A uterine MMMT can be either homologous or heterologous. 

Similar to MMMT's in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components.  Usually, the epithelial component dominates 2

Prevalent sub types for the epitheloid component include:

Prevalent sub types for the sarcomatoid component include:

Radiographic features

Uterine MMMT's commonly present as an intracavitary mass with coexistent dilatation of the endometrial canal.

Ultrasound

Often hyperechoic on ultrasound 1.

CT

Often heterogeneously hypodense and ill-defined on contrast-enhanced CT 1. Dilatation of uterine cavity can be appreciated the vast majority of cases.

MRI

They are not considered to have a pathognomonic appearance on MRI, with appearances often indistinguishable from those of endometrial adenocarcinoma.

However reported general signal characteristics include 3.

  • T1: predominantly isointense to both myometrium (~75%) and endometrium (~70%)
  • T2
    • hyper-intense to myometrium (~90%) 
    • either hypo-intense (~55%) or isointense (~41%) to endometrium
  • C+ dynamic contrast
    • <1 min: hypointense (~40%) or isointense (33%) to myometrium
    • 1-4 min: hypointense (~60%) to myometrium  
    • >4 min: isointense (56%) to myometrium

Prognosis 

Like other malignant mixed Mullerian tumours, they are highly aggressive tumours and carry a poor prognosis. 

Differential diagnosis

General considerations include:

See also

  • -<p><strong>Malignant mixed Mullerian tumour (MMMT) </strong><strong>of the uterus</strong>, also known a <strong>uterine carcinosarcoma</strong>, is the commonest (up to 50%) <a href="/articles/uterine-sarcoma">uterine sarcomas</a>. They are thought to account for 2-8% of all malignant uterine cancers <sup>1-2</sup>. The uterus is the commonest site for <a href="/articles/malignant-mixed-mullerian-tumour">malignant mixed Mullerian tumours</a> <sup>1</sup>. </p><h4>Pathology</h4><p>A uterine MMMT can be either homologous or heterologous. </p><p>Similar to MMMT's in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components.  Usually, the epithelial component dominates <sup>2</sup>. </p><p>Prevalent sub types for the epitheloid component include:</p><ul>
  • +<p><strong>Malignant mixed Mullerian tumour (MMMT) </strong><strong>of the uterus</strong>, also known a <strong>uterine carcinosarcoma</strong>, is the commonest (up to 50%) <a href="/articles/uterine-sarcoma">uterine sarcoma</a>. They are thought to account for 2-8% of all malignant uterine cancers <sup>1-2</sup>. The uterus is the commonest site for <a href="/articles/malignant-mixed-mullerian-tumour">malignant mixed Mullerian tumours</a> <sup>1</sup>. </p><h4>Pathology</h4><p>A uterine MMMT can be either homologous or heterologous. </p><p>Similar to MMMT's in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components.  Usually, the epithelial component dominates <sup>2</sup>. </p><p>Prevalent sub types for the epitheloid component include:</p><ul>

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