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Radical abdomino-pelvic surgery in the management of uterine carcinosarcoma with concomitant para-aortic lymphadenopathy metastasising from anal carcinoma
  1. Imogen Cowdell1,
  2. Sarah Louise Smyth1,
  3. Sally Eltawab2 and
  4. Hooman Soleymani majd2
  1. 1Department of Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  2. 2Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Dr Hooman Soleymani majd; hooman.soleymani{at}


Uterine carcinosarcomas are aggressive gynaecological cancers comprising less than 5% of uterine malignancies. We present the case of a woman in her 70s with a complicated history of advanced anal carcinoma treated with pelvic radiotherapy and multiple laparotomies, who was referred to gynae-oncology following MRI surveillance imaging showing evidence of endometrial carcinoma and para-aortic lymphadenopathy. Successful surgical excision required multidisciplinary teamwork between gynae-oncology, colorectal and urology surgeons. The patient underwent midline laparotomy, with adhesiolysis, ileum resection and side to side anastomosis, posterior exenteration, left kidney mobilisation and suspension, para-aortic lymph node debulking and left ureteric stent insertion. Significant challenge was posed by the extensive adhesions from previous laparotomies and the debulking of the para-aortic lymph nodes around the renal vessels. This case demonstrates the importance of a multidisciplinary approach in complex pelvic surgery and the vitality of good communication between colleagues in achieving effective patient care.

  • Obstetrics, gynaecology and fertility
  • Surgical oncology

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  • Contributors IC is the primary manuscript author. SS gave draft guidance and performed senior review of the case report. SE performed senior review of the case report and was involved in the clinical care of the patient. HSM conceptualised the manuscript, performed senior review of the case report and was involved in the clinical care of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.