Uterine Carcinosarcoma - A case series at Tertiary Care Hospital

Uterine carcinosarcomas (UCS) are uncommon and aggressive biphasic tumors representing <5% of all uterine malignancies. These are aggressive & biphasic neoplasms that are defined as tumors consisting of high grade malignant epithelial & mesenchymal elements. These tumors show a mixture of carcinomatous component and a sarcomatous component (SC) that can be either homologous or heterologous. The aim of our study was to evaluate prognostic factors in uterine carcinosarcoma. It was a retrospective study of two years with 8 cases being diagnosed during this time. 75% of the cases presented as large, solid growth & 25% as polypoid growth. In epithelial component, serous carcinoma (62.5%) was predominant followed by Endometroid carcinoma (37.5%). In Sarcomatous component, we had spindle cell sarcoma without any obvious differentiation in 4/8 cases (50%). Remaining 4 cases showed sarcomatous differentiation (3 cases of Rhabdomyosarcoma [37.5%] & 1 case of chondrosarcoma [12.5%]). 50% of cases presented with advanced FIGO stage (III & IV) with tumor extension to uterine serosa, cervix, omentum and vagina. 50% cases had increased depth of invasion (>2/3rd) while as 3 cases (3/8) showed superficial depth of invasion (<2/3rd). 1 case (1/8) had no depth. Our study reported that prognostic factors like advanced stage and deep myometrial invasion were associated with poor outcome. Our study confirmed the commonly established facts about UCS: these are rare and aggressive uterine tumors with advanced stage, depth of invasion & heterologous sarcomatous component which are associated with poor prognosis & outcome.