ETUDE RETROSPECTIVE SUR NEUF CAS DE CARCINOSARCOMES UTERINS

Thesis subject: uterine carcinosarcomas.Uterine carcinosarcomas or malignant mixed Muller tumors are rare and aggressive tumors, with poor prognosis, and represent less than 5% of all malignant tumors of the uterine body.These tumors are twice as frequent in black patients as in white ones. Purpose: This study aims to specify the epidemiological characteristics of our patients, to identify the diagnostic problem, clinical as well as radiological, and discuss the therapeutic management. Material And Methods: This is a retrospective study of nine cases of patients who were treated between 2013 and 2016 at the Department of Gynecologyand Obstetrics 1 at Hassan University Hospital Center 2. Results : The average age of our patients ranges from 50 to 80 years with an average age of 65 years. Of the nine patients, 95% are large multiparous, and all are menopausal. All our patients consulted for postmenopausal metrorrhagia with pelvicpain. Paraclinically, we performed a pelvic ultrasound in all patients, whose resultswere in favor of an increase in the size of the uterus, with the presence in endocavity of a heterogeneous echogenic image that invades the myometrium in places. A pelvic MRI showed in the nine cases, a voluminous endo-uterine process, with heterogeneous enhancement after contrast. The patients benefited from adiagnostic hysteroscopy with biopsy that favored a uterine carcinosarcoma. All ourpatients received surgical treatment, except for 2 patients who were found be inoperable and sent for radiotherapy. The pathological analysis was in favor of amalignant mixed malignant tumor associating carcinoma and endometrial stromalsarcoma with invasion of more than 50 of the my ometrium. In the nine cases, fivepatients were referred oncology, to receive chemotherapy and radiotherapy, a patient was scheduled postoperatively for chemotherapy, but died twenty days after the intervention. The other patients have been lost. Conclusion: Uterine carcinosarcomas are rare aggressive tumors that have been the subject of little study. First-line treatment will be surgical. Adjuvant chemotherapy has shown interest in this type of tumor. The place of radiotherapy remains to be discussed.