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Sarcomas of Uterine Cervix: Clinicopathological Features, Treatment, and Outcome

Khosla, Divya MD*; Gupta, Ruchi MD; Srinivasan, Radhika MD; Patel, Firuza D. MD*; Rajwanshi, Arvind MD

International Journal of Gynecological Cancer: July 2012 - Volume 22 - Issue 6 - p 1026–1030
doi: 10.1097/IGC.0b013e31825a97f6
Cervical Cancer

Objective: Sarcomas constitute less than 1% of all cervical malignancies. The objective of this study was to determine the presentation, pathological findings, treatment, and outcome of patients with cervical sarcoma.

Methods and Materials: A retrospective analysis of 8 cases of cervical sarcoma diagnosed over a 4-year period from 2006 to 2009 was carried out. The medical records of all patients were reviewed. All pathologic specimens were reviewed by a single pathologist.

Results: Of 1804 patients with cervical malignancies, 8 cervical sarcomas were identified. All patients presented with vaginal bleeding and discharge. The lesions were clinically staged as IB2 (3), II B (1) and IIIB (4). Three patients had leiomyosarcoma, 4 patients had a diagnosis of undifferentiated endocervical sarcoma, and one had embryonal rhabdomyosarcoma. Of the 8 patients, 3 absconded after diagnosis. Primary surgery was done in 3 patients of which 2 patients received adjuvant radiotherapy and chemotherapy and one patient absconded after surgery. Primary radiotherapy was given in 2 patients. Three of 8 patients treated with combined modality treatment remain alive and disease free at the last follow-up.

Conclusions: Cervical sarcomas are rare neoplasms and represent a spectrum on histopathology. Most patients present with vaginal bleeding and a bulky cervical mass at the time of diagnosis. The optimal management of these tumors is uncertain owing to its rarity; however, combined modality treatment can result in prolonged survival and cure.

*Department of Radiotherapy and Oncology, Regional Cancer Centre, and †Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Address correspondence and reprint requests to Firuza D. Patel, MD, Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, UT, 160012, India. E-mail: firuzapatel@gmail.com.

The authors declare that there are no conflicts of interest.

Received March 15, 2011

Accepted April 16, 2012

Copyright © 2012 by IGCS and ESGO