Ovarian malignant mesenchymal mixed tumors

　　The cause of ovarian malignant mesenchymal mixed tumors is unknown. Most scholars believe that it may originate from the surface epithelium of the ovary and the ovarian stroma or occur in ectopic endometrium in the ovary. Some scholars reported that ovarian carcinosarcoma may be related to radiotherapy, and the exact etiology needs to be further explored. The characteristics of ovarian malignant mesenchymal mixed tumors are as follows:

　　1. Gross features

　　Tumors are mostly solid or cystic, with an irregular surface, grayish white color, and areas of hemorrhage. The cut surface sometimes presents as solid yellowish white areas, with extensive hemorrhage and necrosis. Most have extensive pelvic and abdominal infiltration, and there is often bloody ascites.

　　2. Microscopic features

　　Similar to malignant mesenchymal mixed tumors of the uterus, malignant mesenchymal mixed tumors of the ovary are also composed of malignant epithelial components (adenocarcinoma) and sarcomatous components, mainly poorly differentiated endometrioid adenocarcinoma and serous adenocarcinoma. A few cases may contain mucinous adenocarcinoma or clear cell carcinoma components. The homologous sarcomatous components are similar to endometrial stromal sarcoma, fibrosarcoma, or leiomyosarcoma. Heterogeneous sarcomatous components may contain heterologous components, such as immature cartilage tissue, etc., and are generally referred to as chondrosarcoma, osteosarcoma, rhabdomyosarcoma, etc.

　　The tissue phenotype components of carcinosarcoma are complex. Genetic heterogeneity analysis of the internal tumor tissue reveals the phenomenon of homologous allele loss, and different patterns of allele loss are also consistent with genetic changes in the clonal origin process of the tumor. Immunohistochemistry, cell culture, and molecular genetic studies have proven that carcinosarcoma originates from a single clone. Sonoda et al. found that the wild-type BRCA2 and TP53 genes of the carcinomatous and sarcomatous components of ovarian carcinosarcoma have the same mutation status using microdissection technology and molecular genetic analysis, also confirming that the carcinomatous and sarcomatous components originate from a single clone.

　　The main complications of ovarian malignant mesenchymal mixed tumor are serosal metastasis and peritoneal implantation. Ovarian malignant mesenchymal mixed tumor belongs to malignant tumor with poor prognosis. High-risk groups must be screened regularly and treated in a timely manner.

　　The condition of ovarian malignant mesenchymal mixed tumor develops rapidly. Clinical manifestations are often abdominal pain, distension, discomfort in the stomach, abdominal mass, and symptoms of cancer metastasis, some patients may have abnormal vaginal bleeding and discharge. At the time of consultation, 80% of the patients are in the late stage. Palpation can touch the pelvic mass, generally more than 10 cm, and may have ascites, anemia, and other symptoms.

　　The etiology of ovarian malignant mesenchymal mixed tumor is unknown, so there is no effective preventive measure. It should be done regularly for high-risk groups, early detection, early treatment, and follow-up care.

　　The preoperative diagnosis of ovarian malignant mesenchymal mixed tumor is difficult, mainly relying on postoperative histopathological diagnosis. Imaging examinations and tumor marker detection have limited reference value for diagnosis. The routine examination methods are as follows:
　　1, Laboratory tests:Tumor marker detection.
　　2, Other auxiliary examinations:Abdominal ultrasound, MRI, laparoscopy, and histopathological examination.

　　Recommend several dietary recipes suitable for patients with ovarian malignant mesenchymal mixed tumor.

　　1, Walnut chicken

　　2 eggs, 60 grams of walnut branch.

　　Boil with an appropriate amount of water for one hour, remove the dregs, and eat the eggs. Take once a day, two eggs each time.

　　Indications: For patients with ovarian cancer.

　　2, Mung bean, Job's tears, and pork rib porridge

　　30 grams of Job's tears, 30 grams of mung bean, and 250 grams of pork rib.

　　Boil the porridge, season with salt and oil, and take it regularly. One dose per day, take it regularly.

　　Indications: Weakness in ovarian cancer patients.

　　3, Chinese toon seed and egg

　　2 eggs, 30 grams of Chinese toon seed.

　　Wash the Chinese toon seed and slice it, then cook it with eggs and water. After removing the shell of the egg, cook for another 3 to 5 minutes. Take two eggs each day, and take it regularly.

　　Indications: Abdominal pain and fatigue in ovarian cancer patients.

　　4, Phytolacca acinosa, glutinous rice, and jujube porridge

　　Glutinous rice 100 grams, Phytolacca acinosa 10 grams, jujube 5 pieces, and an appropriate amount of water.

　　Boil the root of Phytolacca acinosa in water, remove the dregs, then add glutinous rice and jujube to cook porridge. Eat on an empty stomach, with slight diarrhea as the limit, do not overdo it.

　　Effects: Promote the defecation and urination, reduce edema and swelling.

　　Indications: Abdominal hydrothorax caused by urinary difficulty due to ovarian cancer.

　　5, Astragalus and Poria Decoction

　　Poria 15 grams, Corydalis 20 grams, white芷 20 grams, herba epimedii 20 grams, astragalus 30 grams, fresh mushrooms 500 grams, edible oil, salt, ginger, scallion, garlic in appropriate amounts.

　　Wash the herbs, wrap them in gauze, and simmer with a black chicken for 2 hours. Take one dose per day, divided into 1 to 2 servings.

　　Function: Tonify Qi and relieve pain.

　　6. Shenqi Invigorating Spleen Soup

　　Tangerine peel 5 grams, ginseng 10 grams, astragalus 10 grams, angelica sinensis 10 grams, longan meat 14 grams, fructus lycii 15 grams, codonopsis pilosula 18 grams, pork ribs 300 grams or a whole chicken.

　　Place the Chinese medicine in a cloth bag, tie it shut, and simmer with pork ribs or chicken with water over low heat for 2 to 3 hours. Remove the cloth bag, season with salt and pepper. Serve 5 small bowls, one small bowl each time, once a day. Eat the meat and drink the soup.

　　Indications: Postoperative adjustment for ovarian cancer.

　　Ovarian malignant mesenchymal mixed tumor is a rare clinical condition, and treatment experience is relatively insufficient. The optimal treatment plan is yet to be explored. Currently, clinical treatment still follows the methods used for soft tissue sarcomas and ovarian cancer.
　　1. Surgical Treatment
　　Treatment mainly involves surgery, with the surgical range similar to that of epithelial ovarian cancer. Early surgery includes bilateral uterine tubes, omentum, appendix, pelvic lymph nodes, and para-aortic lymph node resection. Late-stage surgery includes tumor cell cytoreduction surgery. However, due to the rapid development and high malignancy of the disease, most patients are already in the advanced stage when they seek medical attention, making it difficult to achieve ideal surgical treatment effects.　　
　　2. Chemotherapy and Radiotherapy
　　The sensitivity of chemotherapy for ovarian malignant mesenchymal mixed tumor is different from that of adult soft tissue sarcomas. Monotherapy with cisplatin or ifosfamide is better than combination chemotherapy with doxorubicin (adriamycin) and cisplatin or doxorubicin (adriamycin), and it is expected to improve the efficacy of chemotherapy for ovarian malignant mesenchymal mixed tumor patients and extend their survival period.　　
　　Radiation therapy is not effective for ovarian malignant mesenchymal mixed tumor, and postoperative radiotherapy cannot improve the survival rate of patients.
　　Satisfactory tumor cell cytoreduction surgery combined with platinum-based combined chemotherapy can potentially improve the survival rate of patients with ovarian malignant mesenchymal mixed tumor. New chemotherapy regimens such as paclitaxel, docetaxel, topotecan, gemcitabine (Gemzar), liposomal doxorubicin, and others are also being explored.
　　The overall malignancy of ovarian malignant mesenchymal mixed tumor is high, and the clinical prognosis is extremely poor.