Fig. 130.—Diffuse sarcoma of the mucous membrane of the uterus.
In the later stages ulceration and disintegration of tissue occur.
The cervix is not involved by the disease.
The symptoms of this form of sarcoma resemble those of cancer of the fundus. There are hemorrhage, discharge, and pain.
The discharge is serous, and is less fetid than in cancer, as ulceration takes place later in the course of the disease.
The cervical canal is patulous, and in the polypoid form the tumor may be felt projecting into the cavity of the uterus or protruding from the external os.
The fundus uteri is enlarged and is tender upon pressure. A positive diagnosis can be made only by microscopic examination of curetted or excised tissue.
Sarcoma of the uterine parenchyma, or fibro-sarcoma, or recurrent fibroid, begins in the muscular coat of the uterus. It appears as nodules of various size, which may be interstitial or confined to the muscular coat, submucous or projecting beneath the mucous membrane, or subperitoneal, projecting beneath the peritoneal coat. On section these nodules are pale in appearance and soft in consistency. They are rarely found in the cervix. The submucous form of nodule may become polypoid, project into the cavity of the uterus, and with comparative frequency produce inversion of the uterus.
The nodules of sarcoma differ from those of benign fibroid tumors in the fact that they have no capsule. They cannot be enucleated, but are intimately connected with the surrounding uterine tissue. Metastatic nodules occur in the vagina, the peritoneum, and in other parts of the body.
In the later stages of the disease the nodules disintegrate and break down.