Ovarian Carcinosarcoma: Rhabdomyosarcoma differentiation

Indicates skeletal-muscle lineage in the sarcomatous element. Confirms mixed histology and can signal aggressive biology. Core management is within the OCS framework; systemic orientation may tilt toward sarcoma backbones in select contexts.

• Positive myogenic markers: desmin, myogenin, MyoD1 (often strong nuclear myogenin/MyoD1).
• Epithelial component typically: WT1, PAX8 (Müllerian lineage).
• Classic RMS fusions (PAX3/7–FOXO1) uncommon in OCS but may be checked if suspected.

• High proliferation with frequent TP53 aberrations remains common.
• Myogenic programs (myogenesis transcription factors) in the sarcomatous element.
• No consistent RMS-specific target validated in OCS; testing individualized.

• Higher-grade sarcomatous behavior with rapid growth/necrosis.
• Diagnostic pitfalls: expert pathology review recommended.
• Prognosis still chiefly driven by stage, cytoreduction quality, and performance status.

• Same staging/follow-up principles as OCS.
• MRI pelvis if local anatomy detail would influence surgical planning.

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• Ovarian Carcinosarcoma: Other sarcomatous elements