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(searched for: A Rare and Aggressive Uterine Cancer: Carcinosarcoma)
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Sciprofile linkAli Kord, Behnam Rabiee, Ismail Elbaz Younes, Sciprofile linkKaren L. Xie
Case Reports in Obstetrics and Gynecology, Volume 2020, pp 1-8; doi:10.1155/2020/8816348

Abstract:
Uterine carcinosarcomas are rare and extremely aggressive undifferentiated carcinomas which include both carcinomatous and sarcomatous elements. A 52-year-old female presented with heavy irregular menstrual bleeding for several years and new right elbow pain and swelling. Ultrasound and computed tomography showed a large uterine mass with regional and distant metastatic lymphadenopathy and suspicious findings of osseous metastasis to the right elbow. A biopsy confirmed uterine carcinosarcoma, and the patient underwent chemotherapy and then surgical resection of the uterine mass with palliative radiotherapy of the right elbow. The postoperative imaging showed new metastasis, and the patient was scheduled to start on immunotherapy. Considering the highly invasive nature of uterine carcinosarcomas, timely detection of this cancer using characteristic imaging and pathology findings is of extreme importance to improve the patient’s survival.
Sofia D. Gabrilovich, Yasmin Abedin, Sreevidya Santha, Tracy Wu, Mark Einstein, Nataki C. Douglas, Jenna Z. Marcus
Experimental and Molecular Therapeutics, Volume 80, pp 5218-5218; doi:10.1158/1538-7445.am2020-5218

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World Journal of Surgical Oncology, Volume 18, pp 1-8; doi:10.1186/s12957-020-01929-1

Abstract:
Renal hemangioblastoma (RH) is a very rare benign tumour. Hemangioblastoma most commonly occurs in the central nervous system (CNS), and only few cases of RH have been reported as they occur most commonly as asymptomatic masses found incidentally. Mixed Mullerian tumour (MMT) of the uterus is a rarer and aggressive form of uterine malignancy. The detection of two primary rare tumours incidentally is a rare entity. A 50-year-old female presented with abnormal uterine bleeding which on endometrial sampling was diagnosed as a rare variety of endometrial cancer, i.e. MMT or uterine carcinosarcoma. On preoperative imaging, a renal mass was also detected which was highly vascular and was mimicking renal cell carcinoma (RCC). Fine needle aspiration cytology (FNAC) was done from the renal mass to differentiate between RCC and metastasis, but it showed only blood cells. Patient underwent staging laparotomy for endometrial cancer and frozen section examination of the renal mass which was inconclusive with few atypical cells, and thus, patient underwent radical nephrectomy too. Histopathological examination revealed it to be a RH which is a very rare benign tumour. RH is a rare benign tumour which does not require any treatment in majority of the patients. Only 26 cases of RH outside the CNS have been reported till date. MMT is a rare aggressive uterine tumour with an incidence of 1–2 % of all uterine neoplasms, which metastasizes early, and thus, early identification and treatment is the key. RH needs to be differentiated from RCC to avoid over treatment. Morphological findings are similar in RCC and RH; preoperative FNAC, PET scan, and intraoperative frozen section can be utilized to differentiate the two, in well-circumcised tumours and high index of suspicion. Occurrence of renal mass as an incidental finding in the preoperative work up of uterine malignancy directed us to the differentials of metastasis or another histologically distinct primary tumour. The presence of two rare primary tumours, i.e. RH and MMT in the same patient which are unrelated, is a rare entity.
Aparna Setia, Devender Kumar, Sciprofile linkLovenish Bains, Pallavi Sharma, Anjali Tempe, Varuna Mallaya
Published: 22 June 2020
Abstract:
Introduction: Renal hemangioblastoma (RH) is a very rare benign tumor. Hemangioblastoma most commonly occur in the central nervous system (CNS) and only few cases of RH have been reported as they occur most commonly as asymptomatic masses found incidentally. Mixed Mullerian Tumor (MMT) of the uterus is a rarer and aggressive form of uterine malignancy. The detection of two primary rare tumors incidentally is a rare entity. Case presentation: A 50 years female presented with abnormal uterine bleeding which on endometrial sampling was diagnosed as a rare variety of endometrial cancer i.e., MMT or uterine carcinosarcoma. On preoperative imaging, a renal mass was also detected which was highly vascular and was mimicking Renal Cell Carcinoma (RCC). Fine needle aspiration cytology (FNAC) was done from the renal mass to differentiate between RCC and metastasis but it showed only blood cells. Patient underwent staging laparotomy for endometrial cancer and frozen section examination of the renal mass which was inconclusive with few atypical cells and thus patient underwent radical nephrectomy too. Histopathological examination revealed it to be a RH which is a very rare benign tumor. Discussion: RH is a rare benign tumor which doesn’t require any treatment in majority of the patients. Only 26 cases of RH outside the CNS have been reported till date. MMT is a rare aggressive uterine tumor with an incidence of 1-2 % of all uterine neoplasms, which metastasizes early and thus early identification and treatment is the key. RH needs to be differentiated from RCC to avoid over treatment. Morphological findings are similar in both, preoperative FNAC, PET scan and intraoperative frozen section can be utilized to differentiate in between two in well circumcised tumors and in high suspicion. Occurrence of renal mass as an incidental finding in the preoperative work up of uterine malignancy directed us to the differentials of metastasis or another histologically distinct primary tumor. The presence of two rare primary tumors i.e., RH and MMT in the same patient which are unrelated is a rare entity.
Sciprofile linkJennifer Mceachron, Taryn Heyman, Lisa Shanahan, Van Tran, Monica Friedman, Constantine Gorelick, Katherine Economos, Pankaj K Singhal, Yi-Chun Lee, Marguax J Kanis
International Journal of Gynecologic Cancer; doi:10.1136/ijgc-2020-001315

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Manan Shah, Sanjay R Jain, Gabriela Oprea, Saba Shafi
Journal of Clinical Oncology, Volume 38; doi:10.1200/jco.2020.38.15_suppl.e18106

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Sciprofile linkErin K. Crane, Wendel Naumann, David Tait, Robert Higgins, Thomas Herzog, Jubilee Brown
Published: 28 February 2020
by BMJ
International Journal of Gynecologic Cancer, Volume 30, pp 480-484; doi:10.1136/ijgc-2019-000920

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Aparna Setia, Devender Kumar, Sciprofile linkLovenish Bains, Pallavi Sharma, Anjali Tempe, Varuna Mallaya
Published: 25 February 2020
Abstract:
Introduction Renal hemangioblastoma (RH) is a very rare benign tumor. Hemangioblastoma most commonly occur in the central nervous system (CNS) and only few cases of RH have been reported in literature. They occur most commonly as asymptomatic masses found incidentally. Mixed Mullerian Tumor (MMT) of the uterus is a rarer and aggressive form of uterine malignancy. The detection of two primary rare tumors incidentally is a rare entity. Case presentation A 50 years female patient presented with abnormal uterine bleeding which on endometrial sampling was diagnosed as a rare variety of endometrial cancer i.e., MMT or uterine carcinosarcoma. On preoperative Magnetic resonance imaging (MRI), a renal mass was also detected which was highly vascular and was mimicking Renal Cell Carcinoma (RCC). Fine needle aspiration cytology (FNAC) was done from the renal mass to differentiate between RCC and metastasis but it showed only blood cells. Patient underwent staging laparotomy for endometrial cancer and frozen section examination of the renal mass. Frozen section report was inconclusive with few atypical cells and thus patient underwent radical nephrectomy too. Histopathological examination revealed it to be a RH which is a very rare benign tumor. Discussion Only 14 cases of RH outside the CNS have been reported till date. Occurrence of renal mass as an incidental finding in the preoperative work up of uterine malignancy directed us to the differentials of metastasis or another histologically distinct primary tumor. RH may mimic RCC radiologically. To correctly diagnose RH is important because sporadic RH does not require further treatment and the prognosis is much better than that of RCC. MMT which compromise 1-2% of all uterine neoplasms have higher chance of metastasis than endometroid variety. Conclusion Renal hemangioblastoma is a rare benign tumor which doesn’t require any treatment in majority of the patients. Mixed Mullerian tumor is a rare aggressive uterine tumor which metastasizes early, henceforth early identification and treatment is the key. RH needs to be differentiated from RCC to avoid over treatment. Morphological findings are similar in both, preoperative FNAC, PET scan and intraoperative frozen section can be utilized to differentiate in between two in well circumcised tumors and in high suspicion. The presence of two rare primary tumors i.e., RH and MMT in the same patient which are unrelated is a rare entity.
Salvatore Lopez, Emanuele Perrone, Stefania Bellone, Elena Bonazzoli, Burak Zeybek, Chanhee Han, Joan Tymon-Rosario, Gary Altwerger, Gulden Menderes, Anna Bianchi, et al.
Published: 4 February 2020
Oncotarget, Volume 11, pp 560-570; doi:10.18632/oncotarget.27342

Abstract:
Uterine and ovarian carcinosarcomas (CS) are rare cancers with poor prognosis. Sacituzumab-govitecan (SG) is a new class of antibody-drug-conjugate (ADC) targeting the human-trophoblast-cell-surface marker (Trop-2) conjugated with the active metabolite of irinotecan (SN-38). We evaluated the efficacy of SG against biologically aggressive CS. Trop-2 expression was evaluated in 10 formalin-fixed-paraffined-embedded (FFPE) CS by immunohistochemistry and 9 primary CS cell-lines by flow-cytometry. One Trop-2 low/negative (SARARK14) and two Trop-2 positive (SARARK4, SARARK9) cell-lines were tested in cell-viability assays . The in vivo antitumor activity of SG was tested in xenografts models (ie, SARARK9) with strong Trop-2 expression. Strong/diffuse staining was seen in 30% (3/10) of FFPE tumors and 33% (3/9) of primary CS cell lines. Trop-2 positive cell-lines (SARARK4, SARARK9) showed higher sensitivity to SG in vitro when compared to Trop-2 low/negative (SARARK14) cell lines. In xenografts, twice-weekly intravenous administration of SG for three weeks showed a significant tumor growth inhibition when compared to control, to ADC control and to the naked AB (p=0.004, p=0.007 and p=0.0007, respectively). SG significantly improved overall survival at 90 days when compared to control groups (p
Catarina Reis-De-Carvalho, Andre Borges, Dusan Djokovic
Journal of Radiology and Clinical Imaging, Volume 3, pp 56-57; doi:10.26502/jrci.2809026

Abstract:
A Rare and Aggressive Uterine Cancer: Carcinosarcoma. PubMed, SCI, Scopus, ESCI, PMC indexed
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