Carcinosarcoma of the uterus

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Malignant mixed Müllerian tumour (MMMT) of the uterus, also known as uterine carcinosarcoma, is the commonest (up to 50%) type of uterine sarcoma. They are thought to account for 2-8% of all malignant uterine cancers ^1-2. The uterus is the commonest site for malignant mixed M ü llerian tumours ¹.

Pathology

A uterine malignant mixed Müllerian tumour can be either homologous or heterologous.

Similar to malignant mixed Müllerian tumours in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components. Usually, the epithelial component dominates ².

Prevalent subtypes for the epithelioid component include:

endometrioid adenocarcinoma: most common epithelioid subtype ²
clear cell carcinoma
mucinous carcinoma
papillary-serous carcinoma

Prevalent subtypes for the sarcomatoid component include:

undifferentiated sarcoma: homologous tumours
rhabdomyosarcoma: heterologous tumours

Radiographic features

A ~~uerine~~uterine malignant mixed Müllerian tumour commonly presents 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 the uterine cavity can be appreciated in 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
- hyperintense to myometrium (~90%)
- either hypointense (~55%) or isointense (~41%) to the 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

Treatment and prognosis

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

Differential diagnosis

General considerations include:

-<p><strong>Malignant mixed Müllerian tumour (MMMT) of the uterus</strong>, also known as <strong>uterine carcinosarcoma</strong>, is the commonest (up to 50%) type of <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 M</a><a title="Malignant mixed Mullerian tumour" href="/articles/malignant-mixed-mullerian-tumour">ü</a><a href="/articles/malignant-mixed-mullerian-tumour">llerian tumours</a> <sup>1</sup>. </p><h4>Pathology</h4><p>A uterine malignant mixed Müllerian tumour can be either homologous or heterologous. </p><p>Similar to malignant mixed Müllerian tumours in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components. Usually, the epithelial component dominates <sup>2</sup>. </p><p>Prevalent subtypes for the epithelioid component include:</p><ul>
+<p><strong>Malignant mixed Müllerian tumour (MMMT) of the uterus</strong>, also known as <strong>uterine carcinosarcoma</strong>, is the commonest (up to 50%) type of <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 M</a><a href="/articles/malignant-mixed-mullerian-tumour">ü</a><a href="/articles/malignant-mixed-mullerian-tumour">llerian tumours</a> <sup>1</sup>. </p><h4>Pathology</h4><p>A uterine malignant mixed Müllerian tumour can be either homologous or heterologous. </p><p>Similar to malignant mixed Müllerian tumours in general, they are composed or both carcinomatous (epithelial) and sarcomatous (mesodermal) components. Usually, the epithelial component dominates <sup>2</sup>. </p><p>Prevalent subtypes for the epithelioid component include:</p><ul>
-</ul><h4>Radiographic features</h4><p>A uerine malignant mixed Müllerian tumour commonly presents as an intracavitary mass with coexistent dilatation of the endometrial canal.</p><h5>Ultrasound</h5><p>Often hyperechoic on ultrasound <sup>1</sup>.</p><h5>CT</h5><p>Often heterogeneously hypodense and ill-defined on contrast-enhanced CT <sup>1</sup>. Dilatation of the uterine cavity can be appreciated in the vast majority of cases.</p><h5>MRI</h5><p>They are not considered to have a pathognomonic appearance on MRI, with appearances often indistinguishable from those of endometrial adenocarcinoma.</p><p>However, reported general signal characteristics include <sup>3</sup>.</p><ul>
+</ul><h4>Radiographic features</h4><p>A uterine malignant mixed Müllerian tumour commonly presents as an intracavitary mass with coexistent dilatation of the endometrial canal.</p><h5>Ultrasound</h5><p>Often hyperechoic on ultrasound <sup>1</sup>.</p><h5>CT</h5><p>Often heterogeneously hypodense and ill-defined on contrast-enhanced CT <sup>1</sup>. Dilatation of the uterine cavity can be appreciated in the vast majority of cases.</p><h5>MRI</h5><p>They are not considered to have a pathognomonic appearance on MRI, with appearances often indistinguishable from those of endometrial adenocarcinoma.</p><p>However, reported general signal characteristics include <sup>3</sup>.</p><ul>

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