{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:07:28Z","timestamp":1761102448378,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Introduction. Ovarian carcinosarcoma (OCS), also known as malignant mixed M\u00fcllerian tumour (MMMT), is one of the rarest histological subtypes of ovarian cancer. It is an aggressive tumour with a dismal prognosis\u2014the median survival of patients is less than two years. The rarity of the disease generates many controversies about histogenesis, prognostic factors and treatment of OCS. Histologically, OCS is composed of an epithelial and sarcomatous component. Case report. In the present case, a patient with bilateral ovarian cysts and bulky paraaortic lymph nodes is reported. Retroperitoneal paraaortic lymph node metastases were the only extrapelvic dissemination of OCS. The patient underwent comprehensive surgical staging procedures, including total abdominal hysterectomy and bilateral salpingo-oophorectomy, supracolic omentectomy and selective para-aortic lymphadenectomy. Histologically the ovarian carcinosarcoma was composed of an epithelial component (high-grade serous adenocarcinoma) and three sarcomatous components (homologous\u2014endometrial stromal cell sarcoma, and heterologous\u2014chondrosarcoma, rhabdomyosarcoma). Immunohistochemistry staining was performed. A postoperative complication (adhesion between the abdominal aorta and terminal ileum causing obstructive ileus) that has never been reported in the medical literature occurred. Conclusion. Carcinosarcomas are carcinomas with epithelial\u2013mesenchymal transition and heterologous differentiation. Retroperitoneal pelvic and paraaortic lymph nodes should be carefully inspected in patients with ovarian tumours. Adhesions between the small bowels and abdominal aorta are possible complications after lymph node dissection in the paraaortic region.<\/jats:p>","DOI":"10.3390\/diagnostics10121073","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T20:56:57Z","timestamp":1607893017000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Ovarian Carcinosarcoma with Retroperitoneal Para-Aortic Lymph Node Dissemination Followed by an Unusual Postoperative Complication: A Case Report with a Brief Literature Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-3095","authenticated-orcid":false,"given":"Stoyan","family":"Kostov","sequence":"first","affiliation":[{"name":"Department of Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yavor","family":"Kornovski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonka","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0731-3937","authenticated-orcid":false,"given":"Deyan","family":"Dzhenkov","sequence":"additional","affiliation":[{"name":"Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Stoyanov","sequence":"additional","affiliation":[{"name":"Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanislav","family":"Stoilov","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4830-6159","authenticated-orcid":false,"given":"Stanislav","family":"Slavchev","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekaterina","family":"Trendafilova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Varna \u201cProf. Dr. Paraskev Stoyanov\u201d, 9002 Varna, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-382X","authenticated-orcid":false,"given":"Angel","family":"Yordanov","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.critrevonc.2018.12.006","article-title":"Ovarian carcinosarcoma: Current developments and future perspectives","volume":"134","author":"Boussios","year":"2019","journal-title":"Crit. 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