24157              ENDOMETRIAL SARCOMA

The patient was a woman aged 78 admitted from a mental hospital. She was dehydrated and there was ascites and large bowel obstruction. Rectal examination showed a mass high up anteriorly and on vaginal examination a uterus enlarged possibly by a fibroid was felt. Examination under anaesthesia was planned but she died suddenly a week after admission. At postmortem there was an old ischaemic softening in the right corpus striatum, internal capsule and caudate nucleus with wasting of the right peduncle and the right side of the pons. There was a multilocular cyst in the right ovary and a smaller cyst in the left ovary.

The specimen is a slice through the uterus to reveal a large submucous fibroid tumour measuring 8 x 6 cms. There is considerable haemorrhagic congestion on the upper half of the tumour and some apparent cellular degeneration in the lower portion. Histology shows a predominating appearance of spindle-celled sarcoma with large myxomatous areas and many large necrotic areas. There are some areas of irregular glandular proliferation, so that the tumour is best regarded as mixed carcino-sarcomatous type.