Uterine Sarcomas in Port Harcourt; Nigeria a 12-Year Clinico-Pathologic Study

Background : Uterine sarcomas are rare gyneacologic malignancies with a high mortality.There is the need to determine its frequency; clinical presentation and histologic variants.This may form the basis for further research and management inorder to reduce the morbidity and mortality associated with it. Design : A 12-year hospital based retros- pective clinico-pathological study. Setting : University of Port HarcourtTeaching Hospital (UPTH); Port Harcourt; Nigeria. Subject: Women with histologically diagnosed uterine sarcomas. Method : Previously prepared histologic slides were retrieved and reviewed to confirm the diagnosis and to ascertain the histological type of the uterine sarcoma. Clinical data such as the age and the mode of presentation were extracted from the case notes; histology request forms and reports. Results:Eleven histological reports satisfied the criteria for the study which accounted for 0.5and 4of total malignancies and gynaecologic malignancies respectively in UPTH during the period under review. Malignant mixed mesodermal tumors was the most common (36.4).The highest frequency of the tumors occurred in the age group 50-59 years (45.5) and abnormal vaginal bleeding was the most common clinical presentation (36.4). Conclusion : Uterine Sarcomas are rare world wide; most common above the age of 50 years; with variable clinical presentations and associated with high morbidity and mortality rate

A review of soft tissue sarcoma

Background : Soft tissue sarcomas (STS) are a heterogeneous group of rare tumours that arise predominantly from the embryonic mesoderm. They present most commonly as an asymptomatic mass originating in an extremity but can occur anywhere in the body; particularly the trunk; retroperitoneum; or the head and neck. They account for about 0.7of all adult malignancies. Method : A review of the literature of STS was undertaken with emphasis on current approach in management. Result : Despite recent advances in the knowledge of the molecular biology of STS; there is yet no identifiable aetiology in most cases. Tru-cut biopsy is a safe; accurate and economical procedure for diagnosing STS. Enough tissue is usually obtained for use in several diagnostic tests such as electron microscopy and cytogenetic analysis. With the advent of Computed Tomography (CT); Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA); tumours can easily be delineated from muscle groups; bone and neurovascular structures. Surgery remains the main potentially curative therapy for STS. In the last two decades; the role of adjuvant radiotherapy has revolutionized the treatment from a situation where amputation was the standard treatment for extremity STS to the present time where limb sparing surgery is appropriate in more than 90of patients. Postoperative adjuvant chemotherapy significantly improves the overall and disease free survival for patients with large size and high grade sarcomas. Conclusion : optimal results of treatment require multidisciplinary interaction between the referring practitioner; the treating surgeon; the pathologist; the radiotherapist and the chemotherapist.1