A case of uterine sarcoma positive for ascites cytology

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Background: Uterine sarcoma is uncommon in gynecological malignancies, and the presence of sarcoma cells in ascites is extremely rare. Case: In a 38-year-old woman who had abdominal distension, a huge abdominal mass, massive ascites and normal sized uterus and ovaries were observed on imaging examination. Ascitic cytology showed large malignant cells both in small clusters and in isolation. The tumor cells exhibited polymorphic and spindle shapes with multinucleation. Occasional mitotic figures were seen. Gynecological malignancy was suspected and surgery was performed. A tumor protruding from the uterine body with a thin stalk was resected. Peritoneal dissemination of the tumor was seen. the histopathological diagnosis with immunohistochemical staining revealed that the tumor was more likely to be an undifferentiated uterine sarcoma than a poorly differentiated leiomyosarcoma of the uterus. Conclusion: Although uterine sarcoma is difficult to diagnose before an operation, this case was positive for malignant cells in the ascitic cytology, and a malignant non-epithelial tumor could be suspected. It is important to know that uterine sarcoma is rare, but sarcoma cells can be seen in peritoneal fluid cytology specimens.
特定非営利活動法人日本臨床細胞学会の論文