Other Malignant Endometrial Tumours

Endometrial stromal sarcoma

  • Rare tumour arising from endometrial stroma
  • Can be low or high grade
  • Cells resemble endometrial stroma
  • Infilrates myometrium and often lymphovascular spaces
  • Typically presents with abnormal uterine bleeding but initial presentation may be as metastasis (most commonly ovary or lung)

Leiomyosarcoma (rare)

  • A malignant smooth muscle tumour commonly displaying a spindle cell morphology
  • Most occur in women >50 years
  • Commonest symptoms abnormal vaginal bleeding, palpable pelvic mass and pelvic pain
  • Poor prognosis even if confined to uterus at time of diagnosis
  • Leiomyosarcoma and endometrial stromal sarcoma share the same staging system which is different to that for endometrial cancer

Carcinosarcoma

  • Mixed tumour with malignant epithelial and stromal elements
  • Heterologous elements commonly seen in about 50% cases (rhabdomyosarcoma, chrondrosarcoma, osteosarcoma)
  • The presence of a rhabdomyosarcomatous component has the worst prognosis
  • Usually associated with a poor outcome