Case reportMechanismReported positiveLimited evidenceTier 3 · early humann = 1
In vivo (Athens, Greece) · May 2026 · case report
endometrial carcinosarcomaendometrial neoplasm
This is a single-patient case report of an 80-year-old woman with endometrial carcinosarcoma whose FDG-PET/CT showed uptake in the uterus and multiple lymph nodes including the right supraclavicular node. Core-needle biopsy of that supraclavicular node showed extensive anthracotic pigment without malignancy, demonstrating a benign cause of FDG uptake that could mimic distant metastasis. The surgical pathology established FIGO stage IIC endometrial carcinosarcoma. The authors emphasize that histologic confirmation of suspicious nodes is essential to avoid misdiagnosis and inappropriate upstaging.
Key findings
- FDG-PET/CT demonstrated FDG uptake in the uterus and right supraclavicular, mediastinal, and hilar lymph nodes.
- Ultrasound-guided core needle biopsy of the right supraclavicular lymph node revealed extensive anthracotic pigment deposition without evidence of malignancy.
- Final diagnosis after surgery was endometrial carcinosarcoma, FIGO stage IIC.
- Authors suggest right supraclavicular nodal anthracosis can cause false-positive FDG-PET/CT findings and that histologic confirmation is essential to avoid misdiagnosis and inappropriate disease upstaging.
Limitations: Single-patient case report — findings may not generalize.; No systematic evaluation of frequency or diagnostic accuracy of anthracosis-related false positives.; No imaging-pathology correlation beyond the sampled supraclavicular node; mediastinal/hilar nodes not reported as biopsied.; No direct demonstration of the proposed variant thoracic duct anatomy (hypothesized mechanism) in this patient..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Human · observationalMixed resultsLimited evidenceTier 3 · early humann = 97
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · Oct 2025 · multicenter retrospective study
uterine carcinosarcomaendometrial carcinosarcomaendometrial neoplasms
This multicenter retrospective study looked at 97 people with very early uterine carcinosarcoma that had not invaded the muscle layer of the uterus. The researchers compared outcomes by where the tumor was found and by whether patients received chemotherapy. Recurrence was common, mostly at distant sites, and the study did not find statistically significant survival differences with chemotherapy.
Reported effects: 5-year recurrence-free survival 63.5% [53.4–75.4], n=97 · overall survival 72% [62.6–82.9], n=97
Key findings
- 29 of 97 patients (29.9%) had a recurrence, mostly with a distant pattern of relapse.
- The 5-year recurrence-free survival was 63.5% and overall survival was 72.0%.
- No significant differences were observed in recurrence-free survival and overall survival based on tumor status.
- The difference in recurrence-free survival and overall survival was not statistically significant based on receipt of chemotherapy.
Limitations: Retrospective observational design; Rare disease with small sample size; Non-randomized treatment selection; Follow-up for survival analysis was limited to 5 years; Potential confounding by indication; No chemotherapy regimen, dose, or timing details provided in the abstract.
This study evaluates outcomes in a rare endometrial cancer subtype and compares adjuvant chemotherapy versus no chemotherapy after surgery.
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Human · observationalMechanismReported positiveLimited evidenceTier 3 · early humann = 56
Gynecologic oncology reports · Sep 2025 · retrospective pathology series
endometrial carcinosarcoma
This retrospective immunohistochemical study examined HER2, nectin-4, and TROP2 expression in 56 endometrial carcinosarcomas. HER2 3+ was present in 7.1% of cases and HER2 2+/3+ expression was associated with serous carcinoma differentiation and largely confined to the carcinomatous component. Nectin-4 was detected in 39.3% (mostly weak) and TROP2 in 62.5% of cases; both were predominantly expressed in the carcinomatous component. The authors note HER2-directed antibody-drug conjugates could be of interest for ECS with serous differentiation and recommend further study of nectin-4 and TROP2 relevance.
Reported effects: HER2 3+ prevalence 7.1%, n=56 · HER2 2+ (equivocal) prevalence 10.7%, n=56 · +5 more
Key findings
- HER2 overexpression (3+) was identified in 4 cases (7.1%).
- An additional 6 cases (10.7%) showed equivocal (2+) HER2 staining.
- HER2 2+/3+ expression was significantly associated with serous carcinoma differentiation (31.0% vs. 3.7%, P = 0.012).
- HER2 2+/3+ expression was largely confined to the carcinomatous component (P < 0.001).
- Nectin-4 was expressed in 39.3% of cases, predominantly weak in intensity, with significantly higher expression in the carcinomatous than in the sarcomatous component (P < 0.001).
- TROP2 expression was observed in 62.5% of cases and was confined to the carcinomatous component, with no strong expression detected.
- No significant correlations were found between marker expression and other clinicopathological variables beyond serous differentiation.
Limitations: Retrospective design; Modest sample size (n=56); Semi-quantitative immunohistochemistry without functional or clinical outcome data; Observational/correlative study — does not assess treatment response to targeted agents.
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Human · observationalMechanismReported negativeModerate evidenceTier 3 · early humann = 6036
The journal of obstetrics and gynaecology research · Sep 2025 · retrospective cohort study
endometrial cancerendometrial carcinosarcoma
This retrospective, population-based cohort study of 6,036 women in England described real-world outcomes after initiation of first adjuvant therapy for high-risk endometrial cancer or endometrial carcinosarcoma. Median real-world disease-free survival (rwDFS) was 4.56 years and median overall survival (OS) was 8.85 years; 45% experienced recurrence and 39% died during follow-up. Recurrence was associated with a 3.23-fold higher risk of death, and rwDFS correlated with OS (Kendall's τ = 0.75).
Reported effects: sample_size 6036, n=6036 · mean follow-up 48 mo, n=6036 · +10 more
Key findings
- 6036 women were included (mean age 67 years; 86% White) with mean follow-up of 48 months.
- 45% of patients experienced recurrence and 39% of patients died due to any cause.
- Median rwDFS from initiation of adjuvant therapy: 4.56 years (95% CI: 4.14-5.12).
- Median OS from initiation of adjuvant therapy: 8.85 years (95% CI: 8.15-9.82).
- Estimated 2-year and 5-year probabilities: rwDFS 0.64 (95% CI: 0.63-0.65) and 0.49 (95% CI: 0.48-0.50); OS 0.78 (95% CI: 0.77-0.79) and 0.60 (95% CI: 0.58-0.61).
- Disease recurrence was associated with a 3.23-fold higher risk of death (p < 0.001).
- Kendall's τ between rwDFS and OS was 0.75 (95% CI: 0.69-0.80, p < 0.001), supporting rwDFS as a surrogate for OS.
Limitations: Retrospective observational design (potential for confounding and bias).; Use of registry data (NCRAS) may limit availability of detailed clinical variables and introduces potential data-recording limitations).; rwDFS was operationalized as time to next treatment or death, a surrogate endpoint rather than confirmed radiographic/pathologic recurrence.; Findings are from England and may not generalize to other settings or populations..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
ReviewMechanismInconclusiveLimited evidenceTier 4 · clinical
Medicina (Kaunas, Lithuania) · Jun 2025 · review
endometrial carcinosarcomaendometrial cancercarcinosarcoma of the endometrium
This is a narrative review of endometrial carcinosarcoma (ECS), a rare, aggressive biphasic endometrial cancer. The authors summarize epidemiology, pathology including that ECS arises from epithelial components undergoing epithelial-to-mesenchymal transition, prognosis, molecular characteristics, and current and novel therapeutic approaches, noting a poor prognosis and limited high-quality trial evidence.
Reported effects: proportion_diagnosed_early 50% · proportion_with_metastatic_lymph_nodes 33% · +1 more
Key findings
- ECS is a rare, aggressive biphasic metaplastic carcinoma with a monoclonal origin composed of epithelial and mesenchymal components.
- The tumor originates from epithelial components that undergo epithelial-to-mesenchymal transition.
- Approximately half of patients are diagnosed at early stage and half at advanced stage.
- More than one-third of women present with metastatic lymph nodes and approximately 10% have distant metastases.
- ECS has the worst prognosis among endometrial cancers compared with other high-grade endometrial carcinomas.
- Surgical resection with adjuvant therapy remains the standard of care in most cases.
- Rarity of ECS limits prospective clinical trials and the development of specific management guidelines.
- The review discusses molecular characteristics and new treatment regimens for primary (early and advanced) and recurrent ECS.
Limitations: This article is a review and presents no new primary data.; The rarity of ECS limits the ability to conduct prospective clinical trials and to establish optimal treatment regimens (stated in abstract).; No specific treatment guidelines exist for ECS, reflecting limited high-quality evidence (stated in abstract)..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Human · observationalMechanismReported positiveLimited evidenceTier 3 · early humann = 8
The American journal of surgical pathology · May 2025 · case series with clinicopathologic evaluation and next-generation sequencing
gynecologic carcinosarcomaendometrial carcinosarcomalower uterine segment carcinosarcomaovarian carcinosarcoma
The authors report a clinicopathologic and genomic analysis of eight gynecologic carcinosarcomas with a mesonephric-like carcinomatous component. Sequencing (done separately for carcinomatous and sarcomatous parts in some tumors) showed identical single-nucleotide variants between components, low tumor mutational burden (<10 mutations/Mb), microsatellite stability, and KRAS codon 12 mutations in all sequenced cases. Additional alterations (eg, PTEN, PIK3CA, ARID1A) were identified in several tumors. This is a small descriptive case series and does not include functional experiments or outcome correlations beyond staging.
Reported effects: n_cases 8, n=8 · mean_age 65.6 · +11 more
Key findings
- Eight cases of gynecologic MLCS (endometrial, lower uterine segment, and ovarian) were identified and evaluated.
- Genomic DNA extraction and NGS were performed separately on carcinomatous and sarcomatous components of 4 tumors and on combined components of 2 tumors.
- The carcinomatous and sarcomatous components were observed to harbor the same single nucleotide variations when sequenced separately.
- All cases had less than 10 mutations/Mb and were microsatellite stable.
- All sequenced cases (6/6, 100%) harbored KRAS point mutations in codon 12 (p.G12D n=2; p.G12A n=2; p.G12V n=2).
- Five cases showed additional alterations including ARID1A, PTEN, PIK3CA, SPOP, TET1, BUB1, LYN and PTPRD.
- Authors suggest the combination of KRAS and PTEN/PIK3CA alterations is consistent with combined endometrioid and mesonephric differentiation in MLCS.
Limitations: Small sample size (8 cases) limits generalizability.; Only 6 tumors underwent NGS (4 separately by component, 2 combined), so not all cases had component-specific sequencing.; Descriptive molecular profiling without functional validation of mutations.; No survival or treatment-outcome correlations reported beyond FIGO stage..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed
Human · observationalMechanismReported positiveLimited evidenceTier 3 · early humann = 80
Frontiers in artificial intelligence · Dec 2024
endometrial carcinosarcoma
The authors developed an explainable machine learning model to predict recurrence-free survival using clinical, histopathological, chemotherapy and surgical data from a cohort of 80 patients with endometrial carcinosarcoma. In this cohort 32.5% of patients experienced recurrence. The model achieved a concordance index (C-index) of 70.00% (95% CI, 59.38-84.74), and the authors state this approach could help discriminate low- versus high-risk patients. The study is presented as a preliminary, first attempt at this task.
Reported effects: recurrence_rate 32.5%, n=80 · C-index 70% [59.38–84.74], n=80
Key findings
- Cohort of 80 endometrial carcinosarcoma patients was analyzed.
- 32.5% of patients experienced recurrence.
- The machine learning model achieved a C-index of 70.00% (95% CI, 59.38-84.74) for ranking survival times.
- Authors conclude ML methods could support clinicians in discriminating low-risk vs high-risk of recurrence.
Limitations: Small sample size (80 patients).; Preliminary approach and described as a first study addressing this task.; No external validation of the model is reported in the abstract.; Observational cohort data (potential for overfitting and limited generalizability)..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Case reportInconclusiveLimited evidenceTier 3 · early humann = 1
Frontiers in oncology · Oct 2024 · case report
endometrial carcinosarcoma
This is a case report describing a rare instance of duodenal metastasis originating from endometrial carcinosarcoma. The abstract notes that endometrial carcinosarcoma contains both carcinoma and sarcoma elements, is aggressive with high recurrence and mortality, most commonly affects postmenopausal women, and typically metastasizes to lymph nodes, lungs, and the peritoneum.
Key findings
- Reported a rare case of duodenal metastasis from endometrial carcinosarcoma.
- Endometrial carcinosarcoma is described as a tumor with both carcinoma and sarcoma components and is typically aggressive with high recurrence and mortality.
- Typical metastatic sites listed in the abstract are lymph nodes, lungs, and peritoneum.
Limitations: Single-patient case report (n=1), so findings are not generalizable.; Abstract provides no details about the patient’s clinical course, treatments, diagnostic imaging, or pathology findings.; No control group or systematic data collection; purely descriptive..
Descriptive clinical case report documenting an uncommon metastatic site for an aggressive endometrial tumor; not an interventional study.
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text
Case reportInconclusiveLimited evidenceTier 3 · early humann = 1
International journal of surgery case reports · Aug 2024 · case report
endometrial carcinosarcomauterine carcinosarcoma
This case report describes a 73-year-old woman who presented with a palpable left breast-tail mass; imaging showed enlarged left axillary lymph nodes with no breast primary. Excisional biopsy of the node showed metastatic disease of gynecologic origin and subsequent pelvic imaging and D&C diagnosed endometrial carcinosarcoma. The authors state this may be the first reported instance of isolated axillary lymph node metastasis from uterine carcinosarcoma presenting without pelvic or abdominal nodal involvement.
Key findings
- Patient: 73-year-old woman presented with a left breast tail palpable mass.
- Breast imaging (sonomammography and MRI) revealed multiple enlarged left axillary lymph nodes with malignant criteria but no suspected malignancy in either breast on imaging.
- Excisional biopsy of an axillary lymph node diagnosed axillary lymph node metastasis from a gynecologic origin.
- Abdominopelvic CT and pelvic MRI identified a suspicious endometrial mass; D&C pathology revealed endometrial carcinosarcoma.
- Authors note this could be the first reported case of isolated axillary lymph node metastasis from uterine carcinosarcoma presenting as the initial symptom without pelvic or abdominal lymph node involvement.
Limitations: Single-patient case report limits generalizability.; No long-term follow-up or outcome data are provided in the abstract.; No systematic comparison group or epidemiologic data.; No mechanistic or molecular analyses reported in the abstract..
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text