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Case Reports
. 2021 Sep;55(3):232-235.
doi: 10.4314/gmj.v55i3.10.

Primary osteosarcoma of the uterus: a report of two cases

Kofi Effah  1 , Edem Hiadzi  2 , Anita Osabutey  1 , Alex K Boateng  1 , Agyeman B Akosa  3 , Jehoram T Anim  3
Affiliations
Case Reports

Primary osteosarcoma of the uterus: a report of two cases

Kofi Effah et al. Ghana Med J. 2021 Sep.

Abstract

Primary extraskeletal osteosarcoma is an uncommon disease and has been reported to affect the uterus only rarely. Less than 20 cases have so far been reported in the English literature. The common clinical presentation is heavy bleeding per vaginam, and in virtually all cases, the diagnosis has been made at an advanced stage of the disease. Various authors have recommended adjuvant chemotherapy, but outcomes have so far been uniformly poor, with survival extended by months rather than years. We present two cases of this rare condition, which were diagnosed four months apart within our histopathology laboratory andconfirmed the very late presentation of the disease in one and the poor survival of both patients.

Funding: None declared.

Keywords: Ghana; Osteosarcoma; Primary; Uterus; extraskeletal.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Enlarged uterus (Case 1). A: Outer surface of the uterus shows a small breach of the myometrium at the fundus, revealing a tumour. B: The cut surface of the uterus showing a tumour filling the uterine cavity.
Figure 2
Figure 2
Micrographs of tumour in Case # 1. A: Shows malignant mesenchymal tumour with stromal deposits of osteoid (H&E x100). B: Higher magnification to demonstrate stromal osteoid (H&E x 400).
Figure 3
Figure 3
Immunostains. A, B and C: Cytokeratin (AE1/AE3). A: Strong positive staining of normal endometrial epithelium is indicated by arrows. Tumour cells (T) show no staining. (A: x100). B & C: Higher magnification to show no staining of tumour cells (x400). D, E and F: Smooth muscle actin (SMA). D and E show positive smooth muscle cells in the wall of normal blood vessels but no staining of tumour cells (T) (D, E &F; x400).
Figure 4
Figure 4
Enlarged, grossly deformed uterus with tumour nodules in Case # 2. A: Outer surface of the uterus. B: Cut surface showing transmural tumour nodules with cervix replaced by tumour.
Figure 5
Figure 5
Micrograph of tumour in Case # 2. A: Malignant mesenchymal tumour with abundant stromal osteoid deposits. B: Tumour showing calcification of osteoid (A & B; H&E x 400).
See this image and copyright information in PMC

References

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