Uterine Carcinosarcoma with Alpha-Fetoprotein-Producing Hepatoid Component: A Case Report and Literature Review
Joshua J X Li1, Jacqueline H S Lee2, Vicky T C Chan3
1Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Case Reports in Pathology
|July 12, 2018
Summary
This study reports a rare uterine carcinosarcoma with a hepatoid component that produced alpha-fetoprotein. Elevated alpha-fetoprotein levels in this patient correlated with disease recurrence and progression.
Area of Science:
- Gynecologic Oncology
- Pathology
- Medical Oncology
Background:
- Postmenopausal vaginal bleeding can indicate gynecologic malignancy.
- Uterine carcinosarcoma is a rare and aggressive tumor.
- Hepatoid differentiation in gynecologic tumors is uncommon.
Observation:
- A 67-year-old woman presented with postmenopausal bleeding and an intrauterine mass.
- Histology revealed endometrioid adenocarcinoma with sarcomatous and alpha-fetoprotein-producing hepatoid components.
- Serum alpha-fetoprotein (AFP) levels were significantly elevated.
Findings:
- The patient underwent hysterectomy, with a postoperative decrease in AFP.
- A rise in AFP preceded biopsy-proven vaginal recurrence and disease progression.
- AFP levels correlated with tumor burden and response to chemotherapy.
Implications:
- This case highlights the utility of serum AFP as a tumor marker in rare uterine malignancies.
- Monitoring AFP may aid in early detection of recurrence and disease progression.
- This unusual tumor histology warrants further investigation into its pathogenesis and behavior.
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