脂肪肉腫様分化を伴う子宮癌肉腫と考えられた1例

Uterine carcinosarcoma with liposarcomatous differentiation：a case report

子宮癌肉腫は上皮成分と間葉系成分からなる二相性悪性腫瘍である。間葉系成分は内膜間質肉腫などの同所性成分や，横紋筋肉腫，軟骨肉腫などの異所性成分に分化しうるが，脂肪肉腫様分化を伴う症例は約1％と極めてまれである^1）。今回我々は，脂肪肉腫様成分を画像で指摘可能であった子宮癌肉腫と考えられた1例を経験したので，文献的考察を交えて報告する。

We report a case of uterine carcinosarcoma with liposarcomatous differentiation in which the liposarcomatous component could be identified on imaging. An octogenarian woman was referred to our hospital for evaluation of a uterine mass detected during workup for fever of unknown origin. CT and MRI demonstrated a polypoid intrauterine mass containing intratumoral fat. Hysterectomy revealed a predominantly sarcomatous tumor composed of rhabdoid cells and atypical lipocytes, supporting a diagnosis of carcinosarcoma with liposarcomatous differentiation. Liposarcomatous differentiation has been reported in only about 1％ of uterine carcinosarcomas, making this an extremely rare case.