Synchronous primary ovarian endometrioid carcinoma and poorly differentiated endometrial stromal sarcoma

Abstract

Introduction: The presence of two concomitant genital malignant tumours is a rare phenomenon with an incidence of 0.7%. They are typically localised in the uterus and ovary, and approximately 50% are identical endometrioid - endometrioid histological type. In the presence of two different histological types of tumours, diagnosis is easier, but because of the small number of reported cases, there are no precise data on their clinical course. Generally, women with synchronous endometrial and ovarian tumours have a better prognosis and are more frequently younger, obese, multiparous and in menopause compared with women who have metastatic ovarian cancer or endometrial cancer. Case Report: In this work, we present a 53-year-old woman who contacted a gynaecologist because of irregular uterine haemorrhaging. The gynaecological exam revealed a tumour protruding through the cervical canal. The biopsy with initial histopathological diagnosis and additional ECHO and CT evaluations indicated the presence of a cervical tumour spreading over the uterus and both uterine adnexa. After surgical intervention, macroscopic and microscopic analyses of the postoperative material showed the simultaneous presence of two different malignancies, ovarian endometrioid carcinoma and poorly differentiated endometrial stromal sarcoma, which infiltrated all layers of the uterus, cervix and both fallopian tubes. Conclusion: The prognosis of synchronous tumours of the ovary and the uterus is primarily dependent on the stage and histological type of each tumour. Because of the rather small number of reported cases, a large part of this phenomenon remains unknown. Our report is the first description of the synchronous occurrence of endometrial ovarian carcinoma and uterine stromal sarcoma.