Synchronous endometrial adenocarcinoma and carcinosarcoma in endometrial polyp

Abstract

Introduction: Carcinosarcoma is a rare gynecological malignancy and it usually follows an aggressive clinical course. Rarely, it can be confined to an endometrial polyp or be synchronous with another gynecological malignancy. Herein, we report a rare case of synchronous carcinosarcoma confined to an endometrial polyp and endometrioid endometrial adenocarcinoma arising from a distinct uterine wall site. Case presentation: A 57-year-old female patient presented with heavy vaginal bleeding. She underwent hysterectomy with bilateral salpingo-oophorectomy for endometrioid endometrial adenocarcinoma that was diagnosed preoperatively through dilation and curettage. Full histopathological examination of the uterine specimen revealed carcinosarcoma confined to a 4 cm endometrial polyp in addition to a stage IA endometrioid endometrial adenocarcinoma which arose from a distinct uterine wall. Conclusion: Having an endometrioid endometrial cancer diagnosis preoperatively through dilation and curettage and at examination of the frozen section specimen following surgical resection should not preclude the standard full histopathological examination of the uterine specimen, since this could reveal an additional uterine malignancy, such as carcinosarcoma. Such a finding would alter the post-operative management, prognosis, and outcome even if it is confined to an endometrial polyp.