Gynaecological pathology: Uterus: Carcinosarcoma
An autopsy specimen from a 71 year old caucasian woman who had never been pregnant . Seventeen years after her menopause she complained of vaginal bleeding. On examination she was grossly obese and pelvic examination confirmed a hard craggy mass in the Pouch of Douglas. A diagnosis of carcinoma of the uterus and fibroids was made. Smears taken showed an adenocarcinoma. Total abdominal hysterectomy with removal of both Fallopian tubes and ovaries was undertaken. The mass in the Pouch of Douglas was confirmed to be a calcified fibroid. The patient made a normal recovery from this operation. Months latter she was readmitted with haematuria and bleeding from the vaginal vault. Examination confirmed the pelvis full of tumour and she died peacefully.