Malignant mixed Mullerian tumours (MMMT) of the ovary, also known as carcinosarcoma of the ovary, are a rare type of mixed ovarian tumour with both epithelial and stromal components.
They are very rare and account for less than 1% of all ovarian cancers. Most women are post-menopausal at the time of presentation and usually between their 6th to 8th decades of life.
Patients often present with an abdominal mass, ascites, and anaemia. As with other ovarian tumours, the presentation can be vague.
MMMT are histologically biphasic tumours with both carcinomatous (epithelial) and sarcomatous (stromal) elements.
On imaging, it is not possible to differentiate carcinosarcomas from other ovarian neoplasms and therefore the diagnosis is essentially based on histopathologic findings. Features common to ovarian neoplasms, in general, may be present.
A high incidence of haemorrhagic ascites has been reported in those with advanced disease 6 reported is >50% of the patients having ascites from the tumours.
Treatment and prognosis
They are malignant aggressive neoplasms 1,3 carrying a poor prognosis even despite a combination of surgical debulking, radiation therapy, and chemotherapy. Metastasis generally involves serosal and peritoneal seeding. Median survival rates reported in the literature range ~7-10 months at the time of initial writing 5.
The FIGO system is commonly used for staging: see ovarian cancer staging.
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