Abstract
Introducción: Reporte de caso de sarcoma mülleriano mixto maligno de cuello uterino, neoplasia extremadamente rara con pocos casos globales documentados. Resumen del caso: Femenina, 60 años, presentó sangrado vaginal leve, intensificándose último mes, sometida a histerectomía total abdominal con salpingooforectomía bilateral. El análisis histopatológico reveló tumor mülleriano mixto maligno con componente heterólogo, invasión a istmo, infiltración linfática y vascular, bordes quirúrgicos libres, ovarios con cuerpos albos, trompas de Falopio y endometrio secretor sin evidencia neoplásica. Discusión: Los sarcomas cervicales son excepcionales, el carcinosarcoma el subtipo más común, seguido por adenosarcoma y leiomiosarcoma. El condrosarcoma cervical es una variante histológica extremadamente rara, el cual destaca por su combinación histológica inusual y su comportamiento agresivo. Conclusiones y recomendaciones: Este caso ilustra desafíos diagnósticos y terapéuticos, debido a su similitud con entidades benignas. Los hallazgos histopatológicos y evolución clínica destacan la necesidad de investigaciones que identifiquen perfiles moleculares específicos para personalizar opciones terapéuticas.
Malignant mixed Müllerian sarcoma of the cervix: Case report
Summary
Introduction: Case report of a malignant mixed Müllerian sarcoma of the cervix, an extremely rare neoplasm with few documented cases worldwide. Case summary: A 60-year-old female presented with mild vaginal bleeding, which intensified in the last month. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological analysis revealed a malignant mixed Müllerian tumor with a heterologous component, isthmus invasion, lymphatic and vascular infiltration, free surgical margins, ovaries with corpora albus, fallopian tubes, and secretory endometrium with no evidence of neoplasia. Discussion: Cervical sarcomas are rare, with carcinosarcoma being the most common subtype, followed by adenosarcoma and leiomyosarcoma. Cervical chondrosarcoma stands out for its unusual histological combination and aggressive behavior. Conclusion: This case of cervical sarcomas illustrates the diagnostic and therapeutic challenges due to their similarity to benign entities; The histopathological findings and clinical course of the case highlight the need for research to identify specific molecular profiles that allow for personalized therapeutic options.
References
Asfer, S., Samsam, S. H., Zakkar, R., & Jarbouh, H. (2024). Uterine carcinosarcoma with heterologous mesenchymal element: a case report of a rare and aggressive tumor. Oxford Medical Case Reports, 2024(2), omad157. https://doi.org/10.1093/omcr/omad157
Al Dallal, H. A., Jacobs, T. H., Bergman, C. L., Narayanan, S., Kaur, A., Al-Quran, S. Z., & Chopra, H. K. (2025). Uterine carcinosarcoma with heterologous osseous elements: a case report of an xtremely rare clinical occurrence with literature review. Frontiers in Oncology, 15, 1505504. https://doi.org/10.3389/fonc.2025.1505504
Desar, I. M. E., Ottevanger, P. B., Benson, C., & van der Graaf, W. T. A. (2018). Systemic treatment in adult uterine sarcomas. Critical reviews in oncology/hematology, 122, 10–20. https://doi.org/10.1016/j.critrevonc.2017.12.009
Kobayashi H, et al. Malignant Müllerian Mixed Tumor of the Uterine Cervix with a Small Cell Neuroendocrine Carcinoma Component: A Case Report and Review of the Literature. (2013). Case Rep Oncol, 6(1):1-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600347/
Lee, C. H., Mariño-Enríquez, A., & Ou, W. B. (2021). Histogenesis of uterine sarcomas: New insights from molecular pathology. Modern Pathology, 34(6), 1123-1134. https://www.nature.com/articles/s41379-02100771-2
NCCN (National Comprehensive Cancer Network). (2025). NCCN Clinical Practice Guidelines in Oncology: Uterine Neoplasms. https://www.nccn.org/guidelines
Parra-Herran, C., Schoolmeester, J. K., Yuan, L., Dal Cin, P., Fletcher, C. D., Quade, B. J., & Nucci, M. R. (2016). Myxoid Leiomyosarcoma of the Uterus: A Clinicopathologic Analysis of 30 Cases and Review of the Literature with Reappraisal of Its Distinction from Other Uterine Myxoid Mesenchymal Neoplasms. The American journal of surgical pathology, 40(3), 285–301. https://doi.org/10.1097/PAS.0000000000000593
Reed, N. S., Mangla, A., & Ray-Coquard, I. (2023). Systemic therapy for uterine sarcomas: Current evidence and future directions. Current Oncology Reports, 25(8), 901-910. https://doi.org/10.1007/s11912-02301432-6
Toro, J. R., Gubin, T., & Mutch, D. G. (2024). Uterine sarcomas: Epidemiology, diagnosis, and treatment in 2024. Obstetrics and Gynecology
Clinics of North America, 51(1), 45-62. https://doi.org/10.1016/j.ogc.2023.11.005
Wright, J. D., Powell, M. A., & Rader, J. S. (2022). Cervical sarcomas: Incidence, outcomes, and risk factors. Gynecologic Oncology, 165(3), 512-519. https://www.sciencedirect.com/journal/gynecologic-oncology
Zhang, T., Feng, R. L., & Wang, H. (2024). High-grade endometrial stromal sarcoma with rare metastases: Case report and review. Frontiers in Oncology, 14, 1058700. https://www.frontiersin.org/articles/10.3389/fonc.2022.1058700/full
