Publication:

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for sarcomatosis from uterine adenosarcoma

Uterine adenosarcoma has poor prognosis and management of this disease is controversial. We describe a case of sarcomatosis secondary to recurrent uterine adenosarcoma who underwent cytoreductive surgery (CS) and hyperthermic intraoperative peritoneal chemotherapy (HIPEC). A 52 year-old female presented with perimenopausal menometrorrhagia. She underwent laparoscopic hysterectomy and bilateral salpingo-oopherectomy with pathology showing uterine adenosarcoma. She developed a pelvic recurrence 2 years later. A pelvic exenteration was then performed and within 8 months, she recurred. CS/HIPEC with Cisplatin was performed. Six weeks post-operatively, the patient was found to have recurrence again. This case describes the use of CS/HIPEC as a treatment modality for uterine adenosarcoma with sarcomatosis. Despite CS and HIPEC, the patient developed an aggressive recurrence within six weeks of her surgery date. We recommend a multidisciplinary approach to this disease with the recognition that CS/HIPEC may offer little benefit as a salvage therapy based on this case.