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Malignant Mixed Mesodermal Tumor
Christine O. Menias, MD; Oguz Akin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Malignant mixed mesodermal tumor (MMMT)
          • Synonyms

            • Malignant mixed müllerian tumor
            • Carcinosarcoma
          • Definitions

            • Malignant neoplasms of uterus composed of both carcinomatous (epithelial issue) and sarcomatous (mesenchymal ) components

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Jantarasaengaram S et al: Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer. Ultrasound Obstet Gynecol. 43(5):569-74, 2014
                                                2. Anupama R et al: Carcinosarcoma of the uterus-a single institution retrospective analysis of the management and outcome and a brief review of literature. Indian J Surg Oncol. 4(3):222-8, 2013
                                                3. Guntupalli SR et al: Wilms' tumor 1 protein and estrogen receptor beta expression are associated with poor outcomes in uterine carcinosarcoma. Ann Surg Oncol. 20(7):2373-9, 2013
                                                4. Lopez-Chardi L et al: Mesonephric carcinosarcoma of the uterine cervix: a case report. Eur J Gynaecol Oncol. 34(4):336-8, 2013
                                                5. Machida H et al: Impact of multimodal therapy on the survival of patients with newly diagnosed uterine carcinosarcoma. Eur J Gynaecol Oncol. 34(4):291-5, 2013
                                                6. Pacaut C et al: Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy. Am J Clin Oncol. Epub ahead of print, 2013
                                                7. Rauh-Hain JA et al: Prognostic determinants in patients with uterine and ovarian carcinosarcoma. J Reprod Med. 58(7-8):297-304, 2013
                                                8. Saglam O et al: AKT, EGFR, C-ErbB-2, and C-kit expression in uterine carcinosarcoma. Int J Gynecol Pathol. 32(5):493-500, 2013
                                                9. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                                10. Tasic L et al: Carcinosarcoma of the uterus in advanced stage: a case report. Eur J Gynaecol Oncol. 34(4):343-6, 2013
                                                11. Wu YC et al: Intramural metastases of rectum from carcinosarcoma (malignant müllerian mixed tumor) of uterine cervix. Clin Nucl Med. 38(2):137-9, 2013
                                                12. Lee EJ et al: Malignant mixed Müllerian tumors of the uterus: sonographic spectrum. Ultrasound Obstet Gynecol. 39(3):348-53, 2012
                                                13. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                                14. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                                15. Genever AV et al: Can MRI predict the diagnosis of endometrial carcinosarcoma? Clin Radiol. 66(7):621-4, 2011
                                                16. Bharwani N et al: MRI appearances of uterine malignant mixed müllerian tumors. AJR Am J Roentgenol. 195(5):1268-75, 2010
                                                17. Kato H et al: Carcinosarcoma of the uterus: radiologic-pathologic correlations with magnetic resonance imaging including diffusion-weighted imaging. Magn Reson Imaging. 26(10):1446-50, 2008
                                                18. Spaziani E et al: Carcinosarcoma of the uterus: a case report and review of the literature. Eur J Gynaecol Oncol. 29(5):531-4, 2008
                                                19. Tanaka YO et al: Carcinosarcoma of the uterus: MR findings. J Magn Reson Imaging. 28(2):434-9, 2008
                                                20. Teo SY et al: Primary malignant mixed mullerian tumor of the uterus: findings on sonography, CT, and gadolinium-enhanced MRI. AJR Am J Roentgenol. 191(1):278-83, 2008
                                                21. Huang GS et al: Serum CA125 predicts extrauterine disease and survival in uterine carcinosarcoma. Gynecol Oncol. 107(3):513-7, 2007
                                                22. Takeuchi M et al: Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol. 15(11):2244-55, 2005
                                                23. Callister M et al: Malignant mixed Mullerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys. 58(3):786-96, 2004
                                                24. Chaudhry S et al: Benign and malignant diseases of the endometrium. Top Magn Reson Imaging. 14(4):339-57, 2003
                                                25. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                                26. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                                27. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                                28. Inthasorn P et al: Analysis of clinicopathologic factors in malignant mixed Mullerian tumors of the uterine corpus. Int J Gynecol Cancer. 12(4):348-53, 2002
                                                29. Ohguri T et al: MRI findings including gadolinium-enhanced dynamic studies of malignant, mixed mesodermal tumors of the uterus: differentiation from endometrial carcinomas. Eur Radiol. 12(11):2737-42, 2002
                                                30. Sahdev A et al: MR imaging of uterine sarcomas. AJR Am J Roentgenol. 177(6):1307-11, 2001
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Malignant mixed mesodermal tumor (MMMT)
                                                        • Synonyms

                                                          • Malignant mixed müllerian tumor
                                                          • Carcinosarcoma
                                                        • Definitions

                                                          • Malignant neoplasms of uterus composed of both carcinomatous (epithelial issue) and sarcomatous (mesenchymal ) components

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Angiographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Other Modality Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Jantarasaengaram S et al: Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer. Ultrasound Obstet Gynecol. 43(5):569-74, 2014
                                                                                              2. Anupama R et al: Carcinosarcoma of the uterus-a single institution retrospective analysis of the management and outcome and a brief review of literature. Indian J Surg Oncol. 4(3):222-8, 2013
                                                                                              3. Guntupalli SR et al: Wilms' tumor 1 protein and estrogen receptor beta expression are associated with poor outcomes in uterine carcinosarcoma. Ann Surg Oncol. 20(7):2373-9, 2013
                                                                                              4. Lopez-Chardi L et al: Mesonephric carcinosarcoma of the uterine cervix: a case report. Eur J Gynaecol Oncol. 34(4):336-8, 2013
                                                                                              5. Machida H et al: Impact of multimodal therapy on the survival of patients with newly diagnosed uterine carcinosarcoma. Eur J Gynaecol Oncol. 34(4):291-5, 2013
                                                                                              6. Pacaut C et al: Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy. Am J Clin Oncol. Epub ahead of print, 2013
                                                                                              7. Rauh-Hain JA et al: Prognostic determinants in patients with uterine and ovarian carcinosarcoma. J Reprod Med. 58(7-8):297-304, 2013
                                                                                              8. Saglam O et al: AKT, EGFR, C-ErbB-2, and C-kit expression in uterine carcinosarcoma. Int J Gynecol Pathol. 32(5):493-500, 2013
                                                                                              9. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                                                                              10. Tasic L et al: Carcinosarcoma of the uterus in advanced stage: a case report. Eur J Gynaecol Oncol. 34(4):343-6, 2013
                                                                                              11. Wu YC et al: Intramural metastases of rectum from carcinosarcoma (malignant müllerian mixed tumor) of uterine cervix. Clin Nucl Med. 38(2):137-9, 2013
                                                                                              12. Lee EJ et al: Malignant mixed Müllerian tumors of the uterus: sonographic spectrum. Ultrasound Obstet Gynecol. 39(3):348-53, 2012
                                                                                              13. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                                                                              14. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                                                                              15. Genever AV et al: Can MRI predict the diagnosis of endometrial carcinosarcoma? Clin Radiol. 66(7):621-4, 2011
                                                                                              16. Bharwani N et al: MRI appearances of uterine malignant mixed müllerian tumors. AJR Am J Roentgenol. 195(5):1268-75, 2010
                                                                                              17. Kato H et al: Carcinosarcoma of the uterus: radiologic-pathologic correlations with magnetic resonance imaging including diffusion-weighted imaging. Magn Reson Imaging. 26(10):1446-50, 2008
                                                                                              18. Spaziani E et al: Carcinosarcoma of the uterus: a case report and review of the literature. Eur J Gynaecol Oncol. 29(5):531-4, 2008
                                                                                              19. Tanaka YO et al: Carcinosarcoma of the uterus: MR findings. J Magn Reson Imaging. 28(2):434-9, 2008
                                                                                              20. Teo SY et al: Primary malignant mixed mullerian tumor of the uterus: findings on sonography, CT, and gadolinium-enhanced MRI. AJR Am J Roentgenol. 191(1):278-83, 2008
                                                                                              21. Huang GS et al: Serum CA125 predicts extrauterine disease and survival in uterine carcinosarcoma. Gynecol Oncol. 107(3):513-7, 2007
                                                                                              22. Takeuchi M et al: Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol. 15(11):2244-55, 2005
                                                                                              23. Callister M et al: Malignant mixed Mullerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys. 58(3):786-96, 2004
                                                                                              24. Chaudhry S et al: Benign and malignant diseases of the endometrium. Top Magn Reson Imaging. 14(4):339-57, 2003
                                                                                              25. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                                                                              26. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                                                                              27. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                                                                              28. Inthasorn P et al: Analysis of clinicopathologic factors in malignant mixed Mullerian tumors of the uterine corpus. Int J Gynecol Cancer. 12(4):348-53, 2002
                                                                                              29. Ohguri T et al: MRI findings including gadolinium-enhanced dynamic studies of malignant, mixed mesodermal tumors of the uterus: differentiation from endometrial carcinomas. Eur Radiol. 12(11):2737-42, 2002
                                                                                              30. Sahdev A et al: MR imaging of uterine sarcomas. AJR Am J Roentgenol. 177(6):1307-11, 2001