The prevalence of breast and thyroid cancers in women with endometriosis: a single-center, retrospective cohort study

Undifferentiated sarcoma is most rare inside this category, and it is difficult to be deal with if existence of both locally advanced disease and multiple end-organs metastases.No effective adjuvant therapy, including chemotherapy and radiation therapy, can provide the enough evidence to improve survivorship after primary debulking surgery.Here we would like to present an interesting case of uterine undifferentiated sarcoma with neck lymph nodes (LNs), auxillary LNs, right adrenal gland, para-aortic & pelvic LNs, uterine body and both adhexae, vagina, vulvar and inguinal LNs metastases.Neoadjuvant chemotherapy with weekly palitaxel and carboplatin before interval debulking surgery were carried out initially because of her unstable condition and unable to perform surgery debulking.A 65-year-old, unmarried, no experience of sexual intercourse, menopausal female was referred from urologist due to incidental finding of right adrenal 7 cm mass under upper abdominal sonographic examination.In addition, she also has a self-palpable lower abdominal mass for years and uterine leiomyoma (multiple, largest 10 cm) was dignosed under gynecological sonography.Whole chest-abdominal computed tomography (CT) scan was performed which showed a 12 cm size uterine complex mass and 7 cm size right adrenal gland, also multiple retroperitoneal lymphadenopathy including neck/subclavian LNs, auxillary LNs, para-aortic & pelvic LNs, inguinal LNs.Examination under anesthesia showed a left vulvar mass, with middle and lower vaginal extension, but free of invasion of upper vagina, fornix and cervix.Endometrial biopsy, cervical biopsy, endocervical curettage, vaginal biopsy and vulvar biopsy were completed.Right adrenal gland CT guide biopsy was also performed by interventional radiologist.Pathology confirmed "undifferentiated sarcoma, probably arising from uterus," positive of metastases of right adrenal gland, vulvar and lower vagina, negative of metastases of cervix and upper vagina.Due to poor respectability of the surgical debulking, leukocytosis, tumor fever and families' preference, primary surgery did not carry out.Neoadjuvant chemotherapy 12 courses with weekly schedule paclitaxel (80 mg/m 2 ) plus carboplatin (AUC2) were completed within 3 months.Excellent tumor markers (cancer antigen [CA]-125, carcinoembryonic antigen, CA-153) response and image response was achieved.Interval maximal debulking surgery were carried out smoothly and now post-operative chemotherapy is till ongoing without any complications.Weekly schedule paclitaxel (80 mg/m 2 ) plus carboplatin (AUC2) probably plays roles to stabilize patient's worse condition, control distant metastatic LNs and increase the resectability of surgery.However, the impact of survivorship is unknown because of the rarity of this kind disease.