Review Article
Uterine Carcinosarcomas (Malignant Mixed Müllerian Tumours): A Review with Special Emphasis on the Controversies in Management
Table 2
Controversies in uterine carcinosarcoma.
| (i) Origins: sarcomatous versus carcinomatous monoclonal versus biclonal versus polyclonal. | (ii) Demographics: more common in Afro-American versus Caucasian women. | (iii) Aetiology: radiation inducible tumour versus metaplastic versus dedifferentiation versus common stem cell. | (iv) Pathogenesis: collision theory versus combination theory versus conversion theory. | (v) Risk factors: beneficial effect of oral contraceptives versus detrimental effect of exogenous estrogens. | (vi) Presentation: symptomatic (pyometra/vaginal bleeding/abdominal pain) versus asymptomatic. | (vii) Microscopic: biphasic components—separated versus merged. | (viii) MRI description: endophytic with architectural obliteration versus exophytic with no invasiveness. | (ix) Sonography: diagnostic use—yes versus no technique—transabdominal versus transvaginal. | (x) Surgery: lymphadenectomy versus nolymph-node dissection. | (xi) Adjuvant therapy: radiotherapy versus chemotherapy versus molecular targeted versus multimodality therapy. | (xii) Radiotherapy: locoregional control versus improved overall survival limited pelvic radiation versus whole abdominal radiation. | (xiii) Chemotherapy: single-agent versus combination versus targeted antineoplastic therapy. | (xiv) Prognostic features: ?significance of tumour size, patient age, and histology of sarcomatous element. |
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