Unique metastatic patterns of uterine carcinosarcoma: A rare autopsy case report

Abstract

Introduction: Uterine carcinosarcoma also called Malignant mixed Mullerian tumor (MMMT) is an extremely rare endometrial malignant tumor of biphasic character consisting of epithelial and mesenchymal components.
Case Description: This paper is a case of a 69-year-old obese woman been clinically evaluated for metastatic lung disease ?primary site  for about a year. There was no history of postmenopausal bleeding per vagina, no offensive vaginal discharge and no family history of  malignancy. She eventually died of metastatic disease and her body brought for postmortem examination.
Findings: Autopsy reported findings of uterine carcinosarcoma (Figure 1) with rare metastases to previously reported sites such as the  cervix, lungs, bladder, stomach and the chest. Also metastasis to atypical more rare sites such as the thyroid, pancreas, adrenals and the  kidneys were found. Histology revealed a biphasic tumor with both epithelial and mesenchymal components (Figure 2).  Immunohistochemistry showed positivity to pancytokeratin and desmin (Figure 3&4).
Conclusions: This is potentially the first documented case of uterine carcinosarcoma metastasizing to the thyroid gland, pancreas and  kidneys. This is to raise the awareness of typical and atypical metastatic sites of endometrial carcinosarcoma, facilitating early diagnosis  and treatment, and thus provides a learning point for clinicians.