CASE N°36 – Ovarian Carcinosarcoma

Clinical History:

Age: 60

Sex: Female

Gynecological examination
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

PET
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 .

MRI abdomen
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 Image:

Cytological speciemen: free fluid in the pelvis

Papanicolaou Stain:

composit pap

May-Grunwald-Giemsa Stain:

composit mgg

Cytoblock

composit citoincluso

Cytological Report:

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 Image:

Histological speciemen: Uterus, ovary, omentum & para-aortic lymphnodes

COMPOSIT IIC

Histological Report:

High grade carcinosarcoma of the endometrium, focally necroticwith 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-.

 

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