{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:21:43Z","timestamp":1756462903200,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,11,16]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2022-252233","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T10:25:34Z","timestamp":1669803934000},"page":"e252233","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Radical abdomino-pelvic surgery in the management of uterine carcinosarcoma with concomitant para-aortic lymphadenopathy metastasising from anal carcinoma"],"prefix":"10.1136","volume":"15","author":[{"given":"Imogen","family":"Cowdell","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-8247","authenticated-orcid":false,"given":"Sarah Louise","family":"Smyth","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Eltawab","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3293-5321","authenticated-orcid":false,"given":"Hooman","family":"Soleymani majd","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"2025082708324452000_15.11.e252233.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.09.023"},{"key":"2025082708324452000_15.11.e252233.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-246710","article-title":"Late presentation during the COVID-19 pandemic of severe procidentia: a high-grade poorly differentiated sarcoma of unknown origin","volume":"15","author":"Pappa","year":"2022","journal-title":"BMJ Case Rep"},{"key":"2025082708324452000_15.11.e252233.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.critrevonc.2021.103369","article-title":"Uterine carcinosarcoma: an overview","volume":"163","author":"Pezzicoli","year":"2021","journal-title":"Crit Rev Oncol Hematol"},{"key":"2025082708324452000_15.11.e252233.4","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.ejogrb.2021.11.423","article-title":"British gynaecological cancer Society (BGCS) uterine cancer guidelines: recommendations for practice","volume":"270","author":"Morrison","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082708324452000_15.11.e252233.5","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.tjog.2012.01.018","article-title":"Uterine carcinosarcoma associated with pelvic radiotherapy for sacral chordoma: a case report","volume":"51","author":"Kahraman","year":"2012","journal-title":"Taiwan J Obstet Gynecol"},{"key":"2025082708324452000_15.11.e252233.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00279-5"},{"key":"2025082708324452000_15.11.e252233.7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ygyno.2011.03.003","article-title":"Pelvic exenteration in gynecologic oncology: a single institution study over 20 years","volume":"122","author":"Benn","year":"2011","journal-title":"Gynecol Oncol"},{"key":"2025082708324452000_15.11.e252233.8","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1111\/1471-0528.16749","article-title":"\u2018Well\u2010leg\u2019 compartment syndrome associated with gynaecological surgery: a perioperative risk\u2010reduction protocol and checklist","volume":"128","author":"Addley","year":"2021","journal-title":"BJOG"},{"key":"2025082708324452000_15.11.e252233.9","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1080\/01443615.2021.1963220","article-title":"Intravascular leiomyomatosis; mimicking low grade endometrial sarcoma","volume":"42","author":"Sadeghi","year":"2022","journal-title":"J Obstet Gynaecol"},{"key":"2025082708324452000_15.11.e252233.10","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-244774","article-title":"Atypical presentation of intravascular leiomyomatosis mimicking advanced uterine sarcoma: modified laterally extended endopelvic resection with preservation of pelvic neural structures","volume":"14","author":"Cowie","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082708324452000_15.11.e252233.11","first-page":"e10283","article-title":"Carcinosarcoma of the uterus: a study from the surveillance epidemiology and end result (SEER) database","volume":"12","author":"Nama","year":"2020","journal-title":"Cureus"},{"key":"2025082708324452000_15.11.e252233.12","doi-asserted-by":"crossref","first-page":"2874","DOI":"10.1007\/s00261-019-02038-8","article-title":"Uterine carcinosarcoma: a primer for radiologists","volume":"44","author":"Ravishankar","year":"2019","journal-title":"Abdom Radiol"},{"key":"2025082708324452000_15.11.e252233.13","article-title":"The role of lymphadenectomy in uterine sarcoma: a clinical practical approach based on retrospective analysis","volume":"34","author":"Hoellen","year":"2014","journal-title":"Anticancer Res"},{"key":"2025082708324452000_15.11.e252233.14","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ygyno.2013.03.025","article-title":"Secondary debulking surgery in ovarian cancer patients with isolated nodal recurrence located in the region above and behind the renal vein","volume":"130","author":"Kato","year":"2013","journal-title":"Gynecol Oncol"},{"key":"2025082708324452000_15.11.e252233.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.10.053"},{"key":"2025082708324452000_15.11.e252233.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)02482-8"},{"key":"2025082708324452000_15.11.e252233.17","doi-asserted-by":"crossref","DOI":"10.1097\/BOT.0b013e3182a5a045","article-title":"Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis","volume":"28","author":"Grigoryan","year":"2014","journal-title":"J Orthop Trauma"},{"key":"2025082708324452000_15.11.e252233.18","doi-asserted-by":"crossref","unstructured":"Publishing Asia B , Stephens MR , Lewis WG , et al . Multidisciplinary team management is associated with improved outcomes after surgery for esophageal cancer [Internet]. Vol. 19, Diseases of the Esophagus, 2006. Available: https:\/\/academic.oup.com\/dote\/article\/19\/3\/164\/2194890","DOI":"10.1111\/j.1442-2050.2006.00559.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:32:56Z","timestamp":1756308776000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,30]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bcr-2022-252233"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252233","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}