Department of Diagnostic Pathology, Faculty of Medicine, University Hospital, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kagawa 761-0793, Japan.
Arch Gynecol Obstet. 2009 Nov;280(5):839-43. doi: 10.1007/s00404-009-1017-0. Epub 2009 Mar 5.
Carcinosarcomas of the uterine cervix are very rare. Most of them have a homologous mesenchymal component, and cervical carcinosarcomas with a heterologous mesenchymal component are limited to nine cases.
A 61-year-old Japanese woman was admitted to the hospital for treatment of a ureteral stone. Imaging studies detected an indistinct cervical mass. A histopathological diagnosis of the cervical biopsy was a carcinosarcoma. A total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy was carried out upon a diagnosis of stage Ib1 cervical carcinosarcoma. Microscopically, the cervical mass revealed a carcinosarcoma consisting of endometrioid adenocarcinoma and chondrosarcoma. Immunohistochemically, p53 was positive in the epithelial and mesenchymal components. Postoperatively, the patient underwent radiation and chemotherapy. She is alive with no evidence of recurrence 5 years and 10 months after the operation.
We suppose that the similar proportion of p53 overexpression in both the epithelial and mesenchymal components may be one of the findings explaining the histogenesis of this tumor by combination theory.
宫颈的癌肉瘤非常罕见。大多数具有同源性间叶成分,而具有异源性间叶成分的宫颈癌肉瘤仅限于 9 例。
一名 61 岁的日本女性因输尿管结石入院治疗。影像学研究发现宫颈有一模糊的肿块。宫颈活检的组织病理学诊断为癌肉瘤。诊断为 Ib1 期宫颈癌肉瘤后,进行了全子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结切除术。显微镜下,宫颈肿块显示癌肉瘤由子宫内膜样腺癌和软骨肉瘤组成。免疫组化显示上皮和间叶成分中 p53 阳性。术后,患者接受了放疗和化疗。手术后 5 年零 10 个月,患者无复发迹象,仍存活。
我们推测上皮和间叶成分中 p53 过度表达的相似比例可能是通过组合理论解释该肿瘤发生机制的发现之一。