Uterine Sarcoma and Carcinosarcoma: A Two-Center Experience in Iran

Background: Uterine sarcomas (US) represent a rare and heterogeneous spectrum of tumors characterized by diverse clinical behaviors and tumor responses. This study aims to assess patient and tumor characteristics and oncologic outcomes.Method: This historical cohort study encompassed all patients with histologically confirmed diagnoses of the US who were referred to two oncology centers affiliated with Mashhad University of Medical Sciences (Iran) between March 2011 and April 2020. Data analyses were conducted using STATA version 14.02. Survival estimation was carried out utilizing the Kaplan-Meier method. The significance level was established at 0.05.Results: A total of 33 patients were included in this study, comprising 23 with US and 10 with carcinosarcoma (CS). The mean age was 49.3 years for CS and 62.4 years for US (P = 0.0001). Nearly all patients were overweight, with a mean body mass index of 27.1 (confidence interval: 25.6-28.7). The majority of patients were diagnosed at an early stage. The Federation of Gynecology and Obstetrics (FIGO) stage, patient's anemia, and surgical resection were identified as significant prognostic factors. The median overall survival was 50.88 ± 5.7 months. The survival rates at 2, 3, and 5 years were 75%, 56%, and 41%, respectively. No significant difference was observed between CS and US regarding overall and disease-free survival.Conclusion: Despite the typical early-stage diagnosis for US patients, the 5-year survival rate remains low. This study underscores the pivotal role of FIGO stage, tumor size, and surgical resection as vital prognostic factors for survival

Papillary Tumor of the Pineal Region with Leptomeningeal Seeding: A Case Report and Literature Review

Papillary tumor of the pineal region (PTPR) is an infrequent neoplasm arising from the ependymal cells of the sub-commissural organ. This tumor entity was incorporated into the World Health Organization (WHO) classification of central nervous system tumors in 2007. Given the propensity for local recurrence observed in PTPR cases and the documented instances of leptomeningeal seeding in previous case reports, it presents a substantial risk of significant morbidity. Due to its rarity, there is no established standard for its management. Surgical intervention constitutes the primary treatment modality, while the role of adjuvant radiotherapy remains ambiguous. In this case report, we present the clinical course of a 46-year-old male diagnosed with PTPR who underwent surgical resection followed by adjuvant radiotherapy. 14 months post-initial treatment, the patient manifested intracranial and spinal metastases in the form of leptomeningeal dissemination. Subsequently, systemic chemotherapy utilizing vincristine and carboplatin was initiated, and the patient exhibited no evidence of disease progression over the last six months