[ Aspects thérapeutiques et pronostiques des sarcomes utérins: à propos de 12 cas de l’Institut National d’Oncologie de Rabat ]
Volume 28, Issue 2, January 2017, Pages 115–120
M. Bamohamed1, H. Saoudi Hassani2, O. Alhaderi3, F. Tijami4, and H. Hachi5
1 Service de gynécologie obstétrique et d’endoscopie gynécologique, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
2 Service de gynécologie obstétrique et d’endoscopie gynécologique, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
3 Service de gynécologie obstétrique et endocrinologie, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
4 Pole gynéco-mammaire, Institut national d’oncologie Université Mohammed V Souissi, Rabat, Morocco
5 Pole gynéco-mammaire, Institut national d’oncologie Université Mohammed V Souissi, Rabat, Morocco
Original language: French
Copyright © 2017 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uterine sarcomas are malignant tumors with poor prognosis. The purpose is to clarify the epidemiological, diagnostic difficulties and therapeutic modalities and prognosis of uterine sarcomas. Twelve cases of uterine sarcomas supported the National Institute of Oncology (2008-2011) were analyzed. The average age is 43.75 years. Patients viewed had the clinical triad of bleeding, pain and / or pelvic mass. On the para-clinical, seven patients had an inconclusive ultrasound, however the scan was performed in all our patients showing a pelvic mass. The realization of the biopsy endometrial curettage led to the diagnosis. All patients underwent a hysterectomy associated with lymph node dissection in cases with carcinomatous component. Histological analysis of surgical specimens objectified 06 carcinosarcomas, 03 leiomyosarcoma, 02 endometrial stromal sarcoma and an adenosarcoma. In our study in discordance with the literature, the mixed mesenchymal tumors (carcinosarcoma and adenosarcoma) are the most common histological type 58.33% followed by pur sarcoma (sarcoma and endometrial stromal leiomyosarcoma) with a frequency of 41.67%. The average age of patients (43.75 years) is consistent with the literature. The classic clinical triad, reported by most authors, was found in the majority of patients. MRI and PET scan are the most successful exams. The diagnosis rests on hysterectomy’s piece. For treatment, surgery with hysterectomy and adnexectomy with or without lymph node dissection followed by external radiation therapy is the gold standard. Indeed, uterine sarcomas are malignant tumors with poor prognosis whose diagnosis is primarily postoperative. Surgery with radiation therapy is the gold standard. Hope rests on new drugs that are being tested.
Author Keywords: uterine sarcomas, pelvic MRI, curettage biopsy, hysterectomy, bilateral adenexectomy.
Volume 28, Issue 2, January 2017, Pages 115–120
M. Bamohamed1, H. Saoudi Hassani2, O. Alhaderi3, F. Tijami4, and H. Hachi5
1 Service de gynécologie obstétrique et d’endoscopie gynécologique, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
2 Service de gynécologie obstétrique et d’endoscopie gynécologique, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
3 Service de gynécologie obstétrique et endocrinologie, Maternité Souissi Université Mohammed V Souissi, Rabat, Morocco
4 Pole gynéco-mammaire, Institut national d’oncologie Université Mohammed V Souissi, Rabat, Morocco
5 Pole gynéco-mammaire, Institut national d’oncologie Université Mohammed V Souissi, Rabat, Morocco
Original language: French
Copyright © 2017 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Uterine sarcomas are malignant tumors with poor prognosis. The purpose is to clarify the epidemiological, diagnostic difficulties and therapeutic modalities and prognosis of uterine sarcomas. Twelve cases of uterine sarcomas supported the National Institute of Oncology (2008-2011) were analyzed. The average age is 43.75 years. Patients viewed had the clinical triad of bleeding, pain and / or pelvic mass. On the para-clinical, seven patients had an inconclusive ultrasound, however the scan was performed in all our patients showing a pelvic mass. The realization of the biopsy endometrial curettage led to the diagnosis. All patients underwent a hysterectomy associated with lymph node dissection in cases with carcinomatous component. Histological analysis of surgical specimens objectified 06 carcinosarcomas, 03 leiomyosarcoma, 02 endometrial stromal sarcoma and an adenosarcoma. In our study in discordance with the literature, the mixed mesenchymal tumors (carcinosarcoma and adenosarcoma) are the most common histological type 58.33% followed by pur sarcoma (sarcoma and endometrial stromal leiomyosarcoma) with a frequency of 41.67%. The average age of patients (43.75 years) is consistent with the literature. The classic clinical triad, reported by most authors, was found in the majority of patients. MRI and PET scan are the most successful exams. The diagnosis rests on hysterectomy’s piece. For treatment, surgery with hysterectomy and adnexectomy with or without lymph node dissection followed by external radiation therapy is the gold standard. Indeed, uterine sarcomas are malignant tumors with poor prognosis whose diagnosis is primarily postoperative. Surgery with radiation therapy is the gold standard. Hope rests on new drugs that are being tested.
Author Keywords: uterine sarcomas, pelvic MRI, curettage biopsy, hysterectomy, bilateral adenexectomy.
Abstract: (french)
Les sarcomes utérins sont des tumeurs malignes rares de mauvais pronostic. L’objectif du travail est de préciser les caractéristiques épidémiologiques, les difficultés diagnostiques ainsi que les modalités thérapeutiques et le pronostic des sarcomes utérins. Douze cas de sarcomes utérins pris en charge à l’institut nationale d’oncologie de rabat (2008-2011) ont été analysés. L’âge moyen est de 43.75 ans. Les patientes ont consulté à l’occasion de la triade clinique métrorragies, douleur et/ou masse pelvienne. Sur le plan para-clinique, sept patientes ont consulté ayant déjà fait une échographie non concluante, cependant le scanner a été réalisé chez toutes nos patientes montrant une masse pelvienne. La réalisation du curetage biopsique de l’endomètre a permis d’évoquer le diagnostic. Toutes nos patientes ont bénéficié d’une hystérectomie associée à un curage ganglionnaire dans les cas avec composante carcinomateuse. L’analyse anatomopathologique des pièces opératoires a objectivé 06 carcinosarcomes, 03 léiomyosarcomes, 02 sarcomes du stroma endométrial et un adénosarcome. Dans notre étude en discordance avec la littérature, les tumeurs mésenchymateuses mixtes (adénosarcome et carcinosarcome) sont le type histologique le plus fréquent 58.33% suivie des sarcomes pures (sarcome du stroma endométrial et léiomyosarcome) avec une fréquence de 41.67%. L’âge moyen des patientes (43.75 ans) concorde avec la littérature. La triade clinique classique retrouvée chez la majorité des patientes est celle rapportée par la plupart des auteurs. L’IRM et PET-scan sont les examens les plus performants. Le diagnostic de certitude est posé sur pièce opératoire. Pour le traitement, la chirurgie avec hystérectomie et annexectomie bilatérale avec ou sans curage ganglionnaire suivie d’une radiothérapie externe est le gold standard. En effet, les sarcomes utérins sont des tumeurs malignes qui demeurent de mauvais pronostic dont le diagnostic est posé essentiellement en post opératoire. La chirurgie avec radiothérapie constituent le gold standard. L’espoir repose sur les nouvelles molécules qui sont en cours d’essai.
Author Keywords: sarcomes utérins, IRM pelvienne, curetage biopsique, hystérectomie totale, annexectomie bilatérale.
How to Cite this Article
M. Bamohamed, H. Saoudi Hassani, O. Alhaderi, F. Tijami, and H. Hachi, “Therapeutic and prognostic of uterine sarcoma: about 12 case report of the National Oncology Institute in Rabat,” International Journal of Innovation and Scientific Research, vol. 28, no. 2, pp. 115–120, January 2017.
