Introduction/Background Carcinosarcoma is a rare and aggressive cancer that combines a sarcomatous and carcinomatous component. Regarding the gynecological area, carcinosarcoma accounts for 2–5% of endometrial cancers and 1% of ovarian cancers.

Methodology A retrospective study was conducted at our institution between January 1st, 2018 and December 1st, 2022, to analyze the data of 113 patients who were hospitalized for endometrial cancer management. Out of these patients, 17 patients were diagnosed with uterine carcinosarcoma and included in the study.

Results The average age at diagnosis was 54.7 years. 9 patients were overweight or obese. All patients consulted for metrorrhagia, with 7 patients being peri-menopausal and 10 being post-menopausal. Some patients also reported pelvic pain, hydrorrhea, altered general condition, and urinary signs. Pelvic ultrasound showed an intracavitary image in 11 patients and suspicious endometrial thickening in 6 patients. However, preoperative histology had a significant number of false negatives and diagnosed carcinosarcoma in only 10 cases. Pelvic MRI classified 2 tumors as FIGO (International Federation of Gynaecology and Obstetrics) 2009 stage Ia, 4 as Ib, 3 as Ic, 1 as II, 5 as IIIa, and 2 as IIIc. Distant metastases were found on CT scans in 2 patients. Surgical treatment was the first-line approach for all our patients, exception made for 2 of them who went through neoadjuvant chemotherapy first. Adjuvant chemotherapy and radiotherapy were also administered to 8 and 3 of patients, respectively. However, 4 patients refused any additional treatment. The median survival of the 8 patients who died was 13 months, 5 patients are still undergoing neoadjuvant chemotherapy/radiotherapy, 4 are lost to follow-up.

Conclusion Uterine carcinosarcomas are rare and aggressive tumors that require prompt attention. Surgical intervention is the recommended first-line treatment, and adjuvant chemotherapy has shown promising results. The role of radiotherapy in the management of carcinosarcoma remains to be further explored.

Disclosures All the authors have no financial disclosure or conflicts of interest with the presented material in this presentation.