Coexistent choriocarcinoma and malignant mixed mesodermal tumor of the uterus

Objective. The purpose of this article is to report a case of coexisting ut erine choriocarcinoma and uterine malignant mired mesodermal tumor (MMMT). The relevant literature is reviewed and possible pathogenesis discussed. Methods. The clinical course and histopathology of the case were reviewed a nd a Medline literature search for other cases was performed. Results. The patient's uterine tumor contained syncytiotrophoblastic and cy totrophoblastic cells that stained positively for the beta subunit of human chorionic gonadotrophin consistent with uterine choriocarcinoma. Pathology also revealed a second distinct neoplasm composed of adenocarcinoma admire d with sarcoma, compatible with a uterine MMMT. The patient experienced met astatic choriocarcinoma to her lungs, lymph nodes, and brain. She suffered a complicated clinical course and died 7 months after her initial diagnosis . The literature search revealed that various gynecologic and nongynecologi c carcinomas with trophoblastic differentiation have been described, but an association with uterine MMMT has not been previously reported. Conclusions. Trophoblastic differentiation and choriocarcinoma associated w ith gynecologic and nongynecologic tumors is rare. We document the presence of uterine MMMT coexisting with uterine choriocarcinoma that followed an a ggressive clinical course and review the possible pathogenesis of this lesi on. (C) 2000 Academic Press.