Uterine carcinosarcomas; A clinicopathological study of four cases and importance of lung metastasis.

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  • TOYODA Shinji
    Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital
  • KAWA Motohiro
    Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital
  • ITANI Yoshio
    Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital
  • YAMAGAMI Keizo
    Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital
  • HIRAOKA Katsutada
    Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital

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  • 子宮体部癌肉腫の４例，とくに肺転移について

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We have experienced 95 women with uterine cancer in the last decade. Four of them were revealed to have sarcomatous component in histopathological specimens. Age of each patient was 60, 66, 69 and 75 years old. The chief complaint in all the cases was postmenopausal genital bleeding. One patient had a medical history of breast cancer, and another one had diabetes mellitus. In three patients, preoperative endometrial cytology was positive: endometrial adenocarcinoma in two cases and endometrial stromal sarcoma in one. Preoperative histological diagnosis were endometrial stromal sarcoma in two cases, endometrial adenocarcinoma in one case and carcinosarcoma in one case. Operations were performed as initial therapies in all the cases. In three of them, each of chemotherapy, irradiation, or both of them was carried out as postoperative adjuvant treatment.<br> Histological gradings of malignancy in glandular component showed well differentiated pattern in one, moderate in two and poor in the other. Clinical stagings revealed stage III in two and stage I in the other two cases. One case of moderately differentiated endometrioid adenocarcinoma and endometrial stromal sarcoma, has survived without any evidence of recurrence for 4 years after surgery. The other three cases presented lung metastases in the postoperative course, which showed a limited response to additional therapies. The periods of postoperative survive of them were 10 months, 1 year 4 months and 2 years 5 months after initial therapy, respectively. There have been very few reports describing that lung metastasis is frequently seen in cases of uterine corporeal carcinosarcoma. However, the presenting cases suggest that routine examination with chest X-ray is important in postoperative following-up of the disease.

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