Carcinosarcomas and mixed mesodermal tumors of the ovary

Mixed epithelial and mesenchymal tumors (carcinosarcomas and mixed mesodermal tumors) are well‐recognized entities in the uterus. It is not widely acknowledged, however, that histologically identical tumors also occur in the ovary, as less than 17 well‐documented examples have been reported to date. A clinical and pathologic study of 13 carcinosarcomas and 14 mixed mesodermal tumors of the ovary in the files of this Institute revealed that the clinical profile of patients with either tumor was similar. Typically, women were postmenopausal and nulliparous. An enlarging abdomen with a mass present for about 5 months was the most common mode of presentation. Grossly, the 2 types of tumors were usually indistinguishable, although by definition the mixed mesodermal tumors contained neoplastc heterologous elements (bone, cartilage, and striated muscle) in addition to carcinosarcomatous foci. The major difference between the 2 groups was in survival. The median survival for patients with mixed mesodermal tumors was 6 months, whereas it was 12 months in women with carinosarcoma. These findings agree with the survival difference noted by Norris and Taylor (1966) for the same neoplasm in the uterus. The differential diagnosis of carcinosarcomas and mixed mesodermal tumors is considered, with an emphasis on the differentiation from malignant teratomas (teratocarcinoma).