Cervix
Mesenchymal / mixed epithelial & mesenchymal tumors
Carcinosarcoma
Author: Branko Perunovic, D.M.
Last author update: 1 May 2007
Last staff update: 6 July 2020
Copyright: 2007-2024, PathologyOutlines.com, Inc.
PubMed Search: Malignant mixed Müllerian tumor cervix
Table of Contents
Definition / general | Case reports | Treatment | Gross description | Microscopic (histologic) description | Cytology description | Positive stains | Molecular / cytogenetics description | Differential diagnosisCite this page: Perunovic B. Carcinosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixMMMT.html. Accessed November 27th, 2024.
Definition / general
- Also called malignant mixed mesodermal tumor or carcinosarcoma (if homologous)
- Rare, < 100 reported cases, less common than leiomyosarcoma
- Most tumors of cervix are extensions from endometrium; may be secondary to radiation therapy for cervical squamous cell carcinoma
- Mean age 50 to 65 years, range 12 to 93 years
- Often confined to uterus at presentation with better prognosis
Case reports
- 12 year old girl with (Eur J Gynaecol Oncol 1988;9:365)
- 61 year old woman with osteosarcomatous component (J Obstet Gynaecol Res 2005;31:404)
- 76 year old woman with heterologous tumor arising in cervical stump (Gynecol Oncol 1983;16:422)
- 80 year old woman with adenoid cystic carcinoma component (Am J Surg Pathol 1995;19:229)
- 84 year old woman with coexisting adenoid basal carcinoma (Int J Gynecol Pathol 2002;21:186)
- Patient with neuroendocrine differentiation (Int J Gynecol Cancer 2002;12:223)
- Patient with initially interpreted high grade sarcoma (Hum Pathol 1988;19:605)
- Patient with subtotal hysterectomy (Gynecol Oncol 1997;67:322)
Treatment
- Usually hysterectomy with or without radiation therapy or chemotherapy (Am J Surg Pathol 1989;13:177)
Gross description
- Polypoid mass with variable necrosis
Microscopic (histologic) description
- May resemble uterine tumor
- Neoplastic epithelial and mesenchymal components
- Usually accompanied by high grade squamous intraepithelial lesion
- Invasive epithelial component may be adenoid basal, adenoid cystic, basaloid squamous cell or keratinizing squamous cell but is usually NOT adenocarcinoma
- Sarcomatous component usually homologous resembling fibrosarcoma or endometrial stromal sarcoma, often with prominent myxoid change (Int J Gynecol Pathol 1998;17:211)
- Heterologous component is usually rhabdomyosarcoma, present in 50%; also chondrosarcoma, liposarcoma
Cytology description
- Conventional pap smear is only 60% sensitive for carcinosarcoma (Am J Clin Pathol 2004;122:434)
- Diagnosis is often carcinoma without a mesenchymal component (Diagn Cytopathol 1992;8:33)
- Findings are often present if advanced stage uterine disease with involvement of lower uterine segment or cervix; usually large numbers of high grade malignant cells with necrosis, occasional mitotic figures, usually no mesenchymal component present (Diagn Cytopathol 2003;28:245, Acta Cytol 2002;46:465)
Positive stains
- Both components - EMA, keratin, vimentin (most)
- Sarcomatous component - muscle specific actin, smooth muscle actin or desmin
Molecular / cytogenetics description
- HPV DNA positive in 8/8 cases (Am J Surg Pathol 2001;25:338)
Differential diagnosis
- Squamous cell carcinoma with sarcoma-like stroma
