Carcinosarcoma
Malignant
Mixed Mullerian Tumour
(MMMT)
Epidemiology:
- Post-menopausal /
elderly
Common sites:
Gross features:
- fleshy
- necrotic
- hemorrhagic
- bulky
- often fill the
uterine cavity
- polypoid
- protrude throught the cervical os
sometimes
- cervical and extrauterine involvement common
- extensive myometrial invasion typically
Histologic features:
- adenocarcinoma and stromal
components:
- may be mixed
- may be distinct
and separate
- epithelial
component may be any type of mullerian
carcinoma or mixtures of different types
- mucinous, squamous,
endometrioid, high-grade papillary, clear
cell, undifferentiated, or mixtures
- multiple stromal differentiations often:
- muscle – smooth or
striated – rhabdomyosarcomatous differentiation
is common
- adipose
- cartilage
- osteoid
- high-grade nuclear
features
- PAS-positive globules common
Immunophenotype:
|
Marker:
|
Sensitivity:
|
Specificity:
|
|
|
|
|
- stromal
cells often stain positively for epithelial cell markers
Molecular features:
Other features:
- highly malignant – 25-30% 5-year survival
- prognosis dictated
by grade and type of adenocarcinoma, as with endometrial carcinomas
- metastases show carcinomatous component usually
- Epithelial and stromal components thought to arise from same cells (metaplastic carcinoma)
- Previous radiation
therapy sometimes
- Tamoxifen may be a risk factor
- No effective
adjuvant therapy
References:
- Robbins 2005
- Sternberg 2004