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Uterine Carcinosarcoma
Douglas Rogers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Malignant mixed müllerian tumor
            • Malignant mixed mesodermal tumor
          • Definitions

            • Malignant uterine neoplasm composed of both carcinomatous (epithelial) and sarcomatous (mesenchymal) components

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Nuclear Medicine 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. Bi Q et al: The value of clinical parameters combined with magnetic resonance imaging (MRI) features for preoperatively distinguishing different subtypes of uterine sarcomas: an observational study (STROBE compliant). Medicine (Baltimore). 99(16):e19787, 2020
                                            2. Abdulfatah E et al: Predictive histologic factors in carcinosarcomas of the uterus: a multi-institutional study. Int J Gynecol Pathol. 38(3):205-15, 2019
                                            3. Cuevas IC et al: Fbxw7 is a driver of uterine carcinosarcoma by promoting epithelial-mesenchymal transition. Proc Natl Acad Sci U S A. 116(51):25880-90, 2019
                                            4. Huang YT et al: Current status of magnetic resonance imaging in patients with malignant uterine neoplasms: a review. Korean J Radiol. 20(1):18-33, 2019
                                            5. Kurnit KC et al: Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecol Oncol. 152(1):31-7, 2019
                                            6. Li Y et al: Outcome of adjuvant radiotherapy after total hysterectomy in patients with uterine leiomyosarcoma or carcinosarcoma: a SEER-based study. BMC Cancer. 19(1):697, 2019
                                            7. Sagebiel TL et al: Uterine carcinosarcomas. Semin Ultrasound CT MR. 40(4):295-301, 2019
                                            8. Denschlag D et al: Uterine carcinosarcomas - diagnosis and management. Oncol Res Treat. 41(11):675-9, 2018
                                            9. 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
                                            10. 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
                                            11. 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
                                            12. Lopez-Chardi L et al: Mesonephric carcinosarcoma of the uterine cervix: a case report. Eur J Gynaecol Oncol. 34(4):336-8, 2013
                                            13. 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
                                            14. Pacaut C et al: Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy. Am J Clin Oncol. 38(3):272-7, 2013
                                            15. Rauh-Hain JA et al: Prognostic determinants in patients with uterine and ovarian carcinosarcoma. J Reprod Med. 58(7-8):297-304, 2013
                                            16. 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
                                            17. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                            18. Tasic L et al: Carcinosarcoma of the uterus in advanced stage: a case report. Eur J Gynaecol Oncol. 34(4):343-6, 2013
                                            19. 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
                                            20. Lee EJ et al: Malignant mixed Müllerian tumors of the uterus: sonographic spectrum. Ultrasound Obstet Gynecol. 39(3):348-53, 2012
                                            21. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                            22. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                            23. Genever AV et al: Can MRI predict the diagnosis of endometrial carcinosarcoma? Clin Radiol. 66(7):621-4, 2011
                                            24. Bharwani N et al: MRI appearances of uterine malignant mixed müllerian tumors. AJR Am J Roentgenol. 195(5):1268-75, 2010
                                            25. 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
                                            26. 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
                                            27. Tanaka YO et al: Carcinosarcoma of the uterus: MR findings. J Magn Reson Imaging. 28(2):434-9, 2008
                                            28. 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
                                            29. Huang GS et al: Serum CA125 predicts extrauterine disease and survival in uterine carcinosarcoma. Gynecol Oncol. 107(3):513-7, 2007
                                            30. 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
                                            31. 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
                                            32. Chaudhry S et al: Benign and malignant diseases of the endometrium. Top Magn Reson Imaging. 14(4):339-57, 2003
                                            33. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                            34. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                            35. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                            36. 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
                                            37. 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
                                            38. Sahdev A et al: MR imaging of uterine sarcomas. AJR Am J Roentgenol. 177(6):1307-11, 2001
                                            Related Anatomy
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Malignant mixed müllerian tumor
                                                      • Malignant mixed mesodermal tumor
                                                    • Definitions

                                                      • Malignant uterine neoplasm composed of both carcinomatous (epithelial) and sarcomatous (mesenchymal) components

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Nuclear Medicine 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. Bi Q et al: The value of clinical parameters combined with magnetic resonance imaging (MRI) features for preoperatively distinguishing different subtypes of uterine sarcomas: an observational study (STROBE compliant). Medicine (Baltimore). 99(16):e19787, 2020
                                                                                      2. Abdulfatah E et al: Predictive histologic factors in carcinosarcomas of the uterus: a multi-institutional study. Int J Gynecol Pathol. 38(3):205-15, 2019
                                                                                      3. Cuevas IC et al: Fbxw7 is a driver of uterine carcinosarcoma by promoting epithelial-mesenchymal transition. Proc Natl Acad Sci U S A. 116(51):25880-90, 2019
                                                                                      4. Huang YT et al: Current status of magnetic resonance imaging in patients with malignant uterine neoplasms: a review. Korean J Radiol. 20(1):18-33, 2019
                                                                                      5. Kurnit KC et al: Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecol Oncol. 152(1):31-7, 2019
                                                                                      6. Li Y et al: Outcome of adjuvant radiotherapy after total hysterectomy in patients with uterine leiomyosarcoma or carcinosarcoma: a SEER-based study. BMC Cancer. 19(1):697, 2019
                                                                                      7. Sagebiel TL et al: Uterine carcinosarcomas. Semin Ultrasound CT MR. 40(4):295-301, 2019
                                                                                      8. Denschlag D et al: Uterine carcinosarcomas - diagnosis and management. Oncol Res Treat. 41(11):675-9, 2018
                                                                                      9. 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
                                                                                      10. 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
                                                                                      11. 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
                                                                                      12. Lopez-Chardi L et al: Mesonephric carcinosarcoma of the uterine cervix: a case report. Eur J Gynaecol Oncol. 34(4):336-8, 2013
                                                                                      13. 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
                                                                                      14. Pacaut C et al: Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy. Am J Clin Oncol. 38(3):272-7, 2013
                                                                                      15. Rauh-Hain JA et al: Prognostic determinants in patients with uterine and ovarian carcinosarcoma. J Reprod Med. 58(7-8):297-304, 2013
                                                                                      16. 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
                                                                                      17. Sutton G: Uterine sarcomas 2013. Gynecol Oncol. 130(1):3-5, 2013
                                                                                      18. Tasic L et al: Carcinosarcoma of the uterus in advanced stage: a case report. Eur J Gynaecol Oncol. 34(4):343-6, 2013
                                                                                      19. 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
                                                                                      20. Lee EJ et al: Malignant mixed Müllerian tumors of the uterus: sonographic spectrum. Ultrasound Obstet Gynecol. 39(3):348-53, 2012
                                                                                      21. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                                                                      22. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                                                                      23. Genever AV et al: Can MRI predict the diagnosis of endometrial carcinosarcoma? Clin Radiol. 66(7):621-4, 2011
                                                                                      24. Bharwani N et al: MRI appearances of uterine malignant mixed müllerian tumors. AJR Am J Roentgenol. 195(5):1268-75, 2010
                                                                                      25. 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
                                                                                      26. 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
                                                                                      27. Tanaka YO et al: Carcinosarcoma of the uterus: MR findings. J Magn Reson Imaging. 28(2):434-9, 2008
                                                                                      28. 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
                                                                                      29. Huang GS et al: Serum CA125 predicts extrauterine disease and survival in uterine carcinosarcoma. Gynecol Oncol. 107(3):513-7, 2007
                                                                                      30. 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
                                                                                      31. 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
                                                                                      32. Chaudhry S et al: Benign and malignant diseases of the endometrium. Top Magn Reson Imaging. 14(4):339-57, 2003
                                                                                      33. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                                                                      34. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                                                                      35. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                                                                      36. 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
                                                                                      37. 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
                                                                                      38. Sahdev A et al: MR imaging of uterine sarcomas. AJR Am J Roentgenol. 177(6):1307-11, 2001