Mesenchymal tumors of the uterus:III. A clinical and pathologic study of 31 carcinosarcomas

Abstract

The clinical and pathologic findings of 31 patients with uterine carcinosarcoma are presented. Carcinosarcomas arose within the endometrium and all but 2 invaded the myometrium and lymphatic spaces. Tumor had spread beyond the uterus in 12 (39%) of patients at the time of initial therapy. None of 8 patients (26%) who were free of cancer at last contact had extra-uterine extension or metastasis. Because the patients with carcinosarcoma had a significantly better survival rate than did a similar group with mixed mesodermal tumors, the 2 types of neoplasms should be separated. The authors believe that carcinosarcomas arise both from multipotent neoplastic cells that have the capacity to form both epithelium and stroma and from multiple neoplastic cell types having fixed potencies. Origin from embryonal rests, primitive analagen, or collision tumors is rejected. Because the distribution of metastatic lesions of uterine carcinosarcomas is similar to that of endometrial carcinomas, surgical management should be similar. It is not clear whether irradiation has any value as treatment.