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- 癌肉瘤（子宫内膜浆液性癌并间质肉瘤）？
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zhongshihua 离线
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liguoxia71 离线
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caotong_1978 离线
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Whenever you have a high grade serous adenocarcinoma with "malignant stromal changes", a carcinosarcoma (MMMT) should be entertained. Ovarian MMMT is very rare and the incidence of MMMT in ovary is varied from recent studies, from about 2 cases/year reported from Yale University, to 3 cases/year from University of Eidinburph and 6 cases/year from Washington University. I do not know exactly the incidence of ovarian MMMT in China, but assuming it is rarely seen too.
Now when you make diagnosis of MMMT of the ovary, the following DDx should considered, searched and excluded out. 1) Teratoid carcinosarcoma: thoroughly exam the specimen and searching for teratoma-like elements especially neuroectodermal differentiation adjacent to the tumor. and 2) Carcinosarcoma-like mural nodule in a borderline tumor especially mucinous borderline tumors.
The relationship between a high grade serous adenocarcinoma and carcinosarcoma is very close. It has been frequently reported that patients with previous serous adenocarcinoma recurred as carcinosarcoma later. It is possible that previous pathologic examination missed sarcomatous elements or possible that carcinosarcoma arising from the millieu of a prior serous adecocarcinoma. The jury is still out on this more academic debate.
Given the obvious sarcomatous elements, I favor a dagnosis of "MMMT(carcinosarcoma) of the ovary".
- 不坠青云之志，长怀赤子之心
