Carcinosarcomas are, overall, rare and aggressive malignancies, representing 5% of uterine malignancies. 1 The biphasic tumour composed of epithelial and mesenchymal elements is considered the result of epithelial transdifferentiation, given shared genetic alterations. 1,2 Heterologous elements, such as rhabdomyosarcoma or chondrosarcoma may be seen. 1,2 However, the presence of neuroectodermal elements is exceedingly rare within the gynaecological tract and may be termed ‘teratocarcinosarcomas,’ with morphological appearances resembling their sinonasal equivalents. Within the literature, there have been eight reported ovarian cases and one reported uterine cervical case of teratocarcinosarcoma, 3 and one uterine carcinosarcoma with immature teratoid-like differentiation. 2 We present a case of a 64-year-old woman, who presented with post-menopausal bleeding and endometrial thickening on pelvic ultrasound. Histological examination of the curettage fragments demonstrated a carcinosarcoma demonstrating heterologous leiomyosarcomatous and rhabdomyosarcomatous differentiation, and a small immature neuroectodermal (teratoid) component. Our findings highlight the need for continued vigilance, recognition and identification of these rare elements to better understand treatment modalities and prognostic implications.
Yan et al. (Sun,) studied this question.