Locally advanced carcinosarcoma of the uterine cervix – a case report

Abstract

Carcinosarcoma, also known as malignant mixed Mullerian tumour, is a rare but aggressive biphasic tumour comprising both epithelial and mesenchymal components.1 A number of theories have been proposed for its pathogenesis, of which the conversion and combination theories have been the most widely accepted.1 Carcinosarcoma constitutes 3% of uterine malignancies, mostly arising from the uterine corpus.1 Carcinosarcoma of the uterine cervix represents only 0.005% of cervical malignancies, and there is a limited understanding of its treatment, prognosis and outcome.2 We describe a case of FIGO stage IVA carcinosarcoma of the uterine cervix in a 48-year-old woman who presented with abdominal pain and heavy menstrual bleeding. Clinical examination and imaging studies showed a cervical mass involving the lower third of the uterus and upper half of the vagina, with infiltration of the posterior bladder wall. Bilateral pelvic and lower retroperitoneal lymphadenopathy was present. Cervical biopsy showed a malignant tumour consisting of homologous sarcomatous areas and nests of moderately to poorly differentiated squamous cell carcinoma. Immunohistochemistry confirmed a diagnosis of carcinosarcoma of the uterine cervix. The patient was referred for urgent palliative radiotherapy and died of disease within three months.