Management challenges of a cervical carcinosarcoma in a premenopausal woman in northern Tanzania: A rare case report and review of current literature.

ABSTRACT

INTRODUCTION AND IMPORTANCE Cervical carcinosarcomas (CCS) are uncommon aggressive gynecological malignancies that typically occur in postmenopausal females. Data on CCS, incidence, clinical presentation, magnitude and management strategies remain scarce especially in Sub-Saharan countries like Tanzania. In this report, we report the rarity of this particular condition in premenopausal woman, the literature surrounding similar reports, and the many challenges that arise in the management of CCS. CASE PRESENTATION We present a redudancy case of a 35-year-old female from Northern Tanzania who presented with vaginal bleeding, foul smelling discharge, and severe abdominal pain intermittently for a year. The Speculum exam revealed a fungating mass on the cervix, and CT confirmed the irregular mass centered in the uterine cervix expanding in the fornices infiltrating the uterine neck. A cervical biopsy revealed carcinosarcoma of the cervix stage IIA. Due to the patient's instability, she was admitted and started on chemotherapy and later on recommended for radiation without surgical intervention. CLINICAL DISCUSSION: In this case report, we discuss the condition's rarity and multiple barriers we encountered during management of this complicated patient with CCS. Choosing an optimal treatment approach was challenging due to the lack of guidelines and available literature as well as the patient's instability. CONCLUSION: his case is notable due to the rarity of this cervical neoplasm especially in premenopausal women and the challenging management of the condition due to a notable lack of treatment recommendations.