Uterine sarcoma
Uterine sarcoma is one of the most severe forms of a malignant type of tumor. The occurrence of the disease is typical for women who are in the menopause period. In some cases, the disease may appear in girls, due to the presence of dysembriogenesis. Tumor formation in modern gynecology is diagnosed mainly on the uterus, excluding the cervical region.
The content of the article:
What is uterine sarcoma?
Classification of uterine sarcoma
Causes of sarcoma
Symptoms of uterine sarcoma
Diagnosis of uterine sarcoma
Treatment of uterine sarcoma
Uterine sarcoma: prognosis, prevention
Uterine sarcoma
Sarcoma is detected in about 7% of all clinical cases and most often occurs against the background of vaginal sarcoma or uterine fibroma, developing in its anatomical node.
What is uterine sarcoma?
Localization of tumor formations is manifested in various morphological structures. Sarcoma can develop in the myotic tissues of the uterus or connective. The latter option is represented by a sarcoma of skeletal origin of the endometrium.
Sarcoma of the myotic walls of the uterus is characterized by the formation of a round shape that does not have clear boundaries from adjacent tissues. When the tumor formation is scraped out, a secret is visible on the incision. The liquid is colored white with pink-gray veins inside. The consistency is a crumb, soft to the touch. In some cases, the inside of the tumor resembles boiled meat. Sarcoma can also have brighter scarlet-red tones. This is due to hemorrhages in the cavity of the formation.
With endometrioid sarcoma of the uterus, tissue growth, the presence of polyps and nodes are visible. In rare cases, localization is scattered.
As the foci of sarcoma grow, it penetrates into the uterine myometrium, in some cases even reaches the parimetry. Internal organs are affected: bladder, intestine. When the uterine fiber is infected, parametritis may occur.
Sarcoma is characterized by rapid growth followed by rapid decay. With the destruction of sarcoma, the formation of cysts occurs.
During the diagnosis of sarcoma, the localization of cellular metastases in the liver, lungs, kidneys, ovaries, bones and spine is visible.
Classification of uterine sarcoma
Localization of tumor formations is manifested in various morphological structures. Sarcoma can develop in the myotic tissues of the uterus or connective. The latter option is represented by a sarcoma of skeletal origin of the endometrium.
Sarcoma of the myotic walls of the uterus is characterized by the formation of a round shape that does not have clear boundaries from adjacent tissues. When the tumor formation is scraped out, a secret is visible on the incision. The liquid is colored white with pink-gray veins inside. The consistency is a crumb, soft to the touch. In some cases, the inside of the tumor resembles boiled meat. Sarcoma can also have brighter scarlet-red tones. This is due to hemorrhages in the cavity of the formation.
With endometrioid sarcoma of the uterus, tissue growth, the presence of polyps and nodes are visible. In rare cases, localization is scattered.
As the foci of sarcoma grow, it penetrates into the uterine myometrium, in some cases even reaches the parimetry. Internal organs are affected: bladder, intestine. When the uterine fiber is infected, parametritis may occur.
Sarcoma is characterized by rapid growth followed by rapid decay. With the destruction of sarcoma, the formation of cysts occurs.
During the diagnosis of sarcoma, the localization of cellular metastases in the liver, lungs, kidneys, ovaries, bones and spine is visible.
Causes of sarcoma
The main factors of the appearance of uterine sarcoma are as follows:
damage to the uterus: surgical abortion, curettage;
injuries during delivery;
embryogenesis;
the presence of uterine polyps, endometriosis;
constant poisoning of the body: nicotine, alcohol, medications;
negative working conditions in which the patient receives a dose of chemically harmful drugs;
chemotherapy of the pelvic organs;
the presence of cervical cancer in the anamnesis;
imbalance of the hormones estrogen and progesterone.
Very often, sarcoma occurs in the nodes of uterine neoplasms such as fibromyoma. Clinically, up to 60% of all cases in which sarcoma manifests itself due to this etiopathogenesis have been recorded.
It is worth noting that women who are pre- and postmenopausal have a higher risk of developing the disease. One of the main reasons for this is a violation of the neuroendocrine system, which undergoes age-related and hormonal disruptions during this period.
Symptoms of uterine sarcoma
A tumor of the uterus at an early stage does not give a full-fledged symptomatology of the manifestation of the disease. The presence of sarcoma in fibromatous nodes is characterized by identical manifestations with uterine fibroma.
In the future, the symptoms of uterine sarcoma depend on the location, the nature of the manifestation, the stage of development. The main characteristic signs of sarcoma:
vaginal discharge is white with an unpleasant, rotten smell during the development of an infectious process inside the mucosa;
violations of the nature of secretions and duration of the menstrual cycle;
pelvic pain syndrome;
the presence of anemia in the late stages of tumor manifestation, as well as general malaise, intoxication, ascites.
Depending on where the focus of the disease develops, symptoms appear in various internal organs. Thus, jaundice is characteristic of liver sarcoma, pleurisy is characteristic of lung tumors, and pain syndrome of the affected part is characteristic of spinal diffusion.
Diagnosis of uterine sarcoma
To detect a uterine tumor , the following diagnostic measures are used:
Gynecological examination. Sarcoma is characterized by signs of vaginal hypertrophy, a cyatonic-tinged neck, and swelling.
Rectovaginal, bimanual studies. The place of localization of the formation, the size of the nodes, their consistency are revealed. Appendages and lymph nodes are diagnosed.
Ultrasound research. Modification of uterine nodes, necrotic plaques are shown. The presence of abnormal blood flow of the uterine cavity is revealed.
Biopsy together with cytology. To detect cells of an atypical nature.
For the diagnosis of sarcoma, laparoscopy, lymphography, hysteroscopy, angiography are also performed. Research methods aimed at detecting disorders of the genitourinary system by renography, urography are used without fail; to identify formations in the lungs (chest X-ray); intestines (irrigoscopy, rectoromanoscopy); liver examination consists in ultrasound examination.
The diagnosis of uterine sarcoma consists of several research methods, during which it is necessary to exclude other possible disorders and diseases of the body:
uterine fibromyoma;
endometrial polyps;
ovarian tumors.
During the collection of anamnesis, it is worth paying attention to such factors that may indicate uterine sarcoma:
increased ESR;
acyclic bleeding;
anemia without signs of sufficient blood loss.
Treatment of uterine sarcoma
For the treatment of sarcoma, a pangisterectomy is used. In the last stages of the disease, complete removal of the uterine organs and appendages, regional lymph nodes, resection of adjacent organs is carried out.
After surgery, further treatment of uterine sarcoma consists of radiation therapy. Its main function is the complete destruction of malignant tumor cells.
To date, the use of chemotherapy is an ineffective method of treating uterine sarcoma. In view of this, its use is impractical. However, on an individual basis, at an early stage of detection of the disease, chemotherapy options based on the following drugs are used:
fluorouracin;
cyclophosphane;
dactinomycin;
vincristine;
doxorubicin.
Chemotherapy is also used for recurrent sarcoma variants.
Uterine sarcoma: prognosis, prevention
Positive dynamics after treatment is observed in patients who have been diagnosed with fibromatous node sarcoma. With an endometrial tumor, the prognosis is disappointing.
Uterine sarcoma has a generally unfavorable prognosis — a maximum of five years of survival. According to clinical data, women with stage I sarcoma survive to this period only in 47% of cases. At stage IV — 10% of patients.
Preventive measures to prevent uterine sarcoma include the following measures:
detection of diseases of the endocrine and neuroendocrine systems, their timely treatment;
hormonal correction of body disorders;
timely treatment of diseases of the reproductive system: endometrial polyps, cysts, uterine endometriosis, uterine fibromyoma, etc.;
choice of contraception in favor of hormonal drugs;
avoiding unwanted pregnancy and, as a result, resorting to surgical abortion.
Preventive methods for the prevention of sarcoma are reduced to a careful and adequate way of daily life. Such prevention will help to avoid other diseases of the reproductive system.
