CASE N°36 – Ovarian Carcinosarcoma
4 years ago histological diagnosis of endometrial hyperplasia (no treatment). Due to of leaks of blood (for about one months) the patient is subjected to ultrasound and instrumental examinations
The analysis of the images shows the presence of extensive pathological tissue intensely hypermetabolic in the pelvis infiltrating the uterus, which are associated with multiple para-aortic denopathies .
Pathological tissue that occupies the entire endometrial cavity, the body of the uterus and cervix with infiltration of the anterior vaginal fornix in the presence of solid tissue with a maximum extension of 94 x 65 mm. Presence of several para-aortic enlarged lymphnodes.
Cytological speciemen: free fluid in the pelvis
Presence of many malignant tumor cells with evident nucleolus, isolated and arranged in small groups. Red blood cells and activated mesothelial cells in the background. Positive for malignancy.
Histological speciemen: Uterus, ovary, omentum & para-aortic lymphnodes
High grade carcinosarcoma of the endometrium, focally necrotic, with focal sarcomatous and muscle phenotype differentiation. Endometrioid epithelial adenocarcinoma component is also present.
pT3b N1 M1 (sec. TNM) IVB (sec. FIGO)
Immunohistochemistry: Ckpool+, CK8/18+, ActinaML +/-, Desmina+, Miogenina -, Vimentina+, CD56+, Sinaptofisina+(few cells), CD99-, CD34-, S100-, CLA-.