Malignant mixed Mullerian tumors (MMMT) of the ovary, also known as carcinosarcoma of the ovary, are a rare type of mixed ovarian tumor 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 anemia. As with other ovarian tumors, the presentation can be vague.
MMMT are histologically biphasic tumors 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 hemorrhagic ascites has been reported in those with advanced disease 6 reported is >50% of the patients having ascites from the tumors.
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.
- 1. Mullins ME, Chao S, Ochoa ER et-al. Ovarian carcinosarcoma [correction of carcinoma]. AJR Am J Roentgenol. 2001;177 (1): 130. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Saito A, Kuwatsuru R, Ogishima D et-al. MR images of ovarian carcinosarcoma. Radiat Med. 17 (6): 447-50. - Pubmed citation
- 3. Varras M, Akrivis Ch, Antoniou N et-al. Primary ovarian carcinosarcoma: a case report and review of the literature. Eur. J. Gynaecol. Oncol. 2004;25 (5): 653-6. - Pubmed citation
- 4. Silasi DA, Illuzzi JL, Kelly MG et-al. Carcinosarcoma of the ovary. Int. J. Gynecol. Cancer. 18 (1): 22-9. doi:10.1111/j.1525-1438.2007.00948.x - Pubmed citation
- 5. Rutledge TL, Gold MA, Mcmeekin DS et-al. Carcinosarcoma of the ovary-a case series. Gynecol. Oncol. 2006;100 (1): 128-32. doi:10.1016/j.ygyno.2005.07.119 - Pubmed citation
- 6. Cicin I, Saip P, Eralp Y et-al. Ovarian carcinosarcomas: clinicopathological prognostic factors and evaluation of chemotherapy regimens containing platinum. Gynecol. Oncol. 2008;108 (1): 136-40. doi:10.1016/j.ygyno.2007.09.003 - Pubmed citation