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2018, Número 1

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Rev Hosp Jua Mex 2018; 85 (1)


Carcinosarcoma uterino. Neoplasia rara y mortal

Vargas-Hernández VM, Vargas-Aguilar VM, Sosa-Durán EE, Aboharp-Hasan Z

Idioma: Español
Referencias bibliográficas: 29
Paginas: 26-38
Archivo PDF: 555.03 Kb.


RESUMEN

El carcinosarcoma es una neoplasia ginecológica rara que pertenece a los tumores müllerianos mixtos. Tiene componentes epiteliales y mesenquimatosos malignos que pueden desarrollarse en cualquier parte del tracto ginecológico, pero es más frecuente en la cavidad uterina, donde representa 5% de las neoplasias malignas. Es agresivo y de mal pronóstico; 30% se presentan extrauterinamente al momento del diagnóstico. Actualmente, se clasifica como carcinoma con elementos de metaplasia sarcomatosa. La exactitud diagnóstica de los marcadores tumorales e imagenología es limitada. La biopsia endometrial es diagnóstica en algunas pacientes. La clasificación y estadificación para sarcomas uterinos se ha actualizado en un intento de reflejar su diferente comportamiento biológico. La incidencia de metástasis ganglionares regionales es alta y la linfadenectomía pélvica y paraaórtica se realizan típicamente para la estadificación y tratamiento. En mujeres con carcinosarcoma avanzado, se sugiere una citorreducción quirúrgica óptima. En estadios Ib-IVa, se utiliza quimioterapia (Qt) con radioterapia (Rt) pélvica o braquiterapia vaginal adyuvantes con la citorreducción óptima.


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