Two cases of carcinosarcoma of the uterine corpus - A review of malignant mixed muellerian tumor in Japan.:—A review of malignant mixed Müllerian tumor in japan—
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概要
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Ninety-seven cases of malignant mixed Müllerian tumor (MMMT) of the uterine corpus have been reported in Japan. We report two occurrences of carcinosarcoma together with a review of the literature and comments on cases of MMMT in Japan. The mean age of women with this tumor is 59.5, the range being from 23 to 77 years. Seventy of the 78 women (89.7%) were postmenopausal. The reported cases have increased since the 1970s. These tumors are usually attached to the posterior uterine wall (64.8%), polypoid (77.1%), and sometimes protruded from the external os of the uterus (22.9%). The diagnosis of MMMT was made preoperatively in 28.8%. The epithelial components were adenocarcinoma 79.8%, squamous cell carcinoma 20.2%, while the non-epithelial components were homologous sarcoma 81.8%, chondrosarcoma 38.4%, rhabdomyosarcoma 36.4%, osteosarcoma 7.1%.The 5-year survival rate was 18.40. There was no direct correlation between histological type of MMMT and survival. There was a prognostic indicator in the extent of tumor at the time of surgery, in that there was a significant difference in 1-year survival when the tumor was limited to the endometrium or inner half of the myometrium and when the tumor included a deeper myometrial invasion or spread beyond the uterus, at a 0.5% confidence level. Since pelvic recurrence, lymphatic and hematogenous spread also occur, Wertheim hysterectomy or Okabayashi hysterectomy with bilateral pelvic node dissection was recommended, as the most effective approach to gain a long term survival.
- 近畿産科婦人科学会の論文
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