Bulky peritoneal carcinosarcoma with tiny high-grade serous carcinoma of the fallopian tube: a case report

Ayaka Nakashima; Yasuyo Maruyama; Haruya Saji; Tomoo Hirabuki; Hiroyuki Mitomi

doi:10.1007/s13691-020-00451-1

Bulky peritoneal carcinosarcoma with tiny high-grade serous carcinoma of the fallopian tube: a case report

Int Cancer Conf J. 2020 Oct 19;10(1):72-77. doi: 10.1007/s13691-020-00451-1. eCollection 2021 Jan.

Authors

Ayaka Nakashima¹, Yasuyo Maruyama¹, Haruya Saji², Tomoo Hirabuki¹, Hiroyuki Mitomi³

Affiliations

¹ Department of Obstetrics and Gynecology, Odawara Municipal Hospital, 46 Kuno, Odawara, Kanagawa 250-8558 Japan.
² Department of Obstetrics and Gynecology, Fujisawa Municipal Hospital, 2-6-1 Fujisawa, Fujisawa, Kanagawa 251-8550 Japan.
³ Department of Diagnostic Pathology, Odawara Municipal Hospital, 46 Kuno, Odawara, Kanagawa 250-8558 Japan.

Abstract

Peritoneal carcinosarcoma is a highly aggressive and uncommon neoplasm that has carcinomatous and sarcomatous components; the malignancy rarely localizes to the omentum. We report a case of a bulky peritoneal carcinosarcoma with tiny high-grade serous carcinoma of the fallopian tube. A 60-year-old female with a huge pelvic mass (12 cm in diameter) underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for tumor debulking. Pathological findings showed minimally invasive high-grade serous carcinoma of the left fallopian tube and carcinosarcoma of the omentum. Similar p53 diffuse immunostaining in the omental carcinosarcoma and the tubal carcinoma provides evidence for a clonal relationship between the two neoplasias. This case suggests a small serous carcinoma, originating in the tubal mucosa, subsequently became implanted in the omentum and grew preferentially, converting to a carcinosarcoma at a remote site.

Keywords: Case report; Conversion theory; Fallopian tube; High-grade serous carcinoma; Peritoneal carcinosarcoma; Serous tubal intraepithelial carcinoma; p53.