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We report a 50-year-old woman case with an extensive necrotizing fasciitis (NF). The NF appeared 10 years after a tension free vaginal tape procedure for urinary stress incontinence. Vital prognosis was engaged due to the initial sepsis severity. This kind of complication is rare and could be under estimated. NF usually appear soon after surgery, whatever within the year following implantation. Anyway, NF are always related to a vaginal erosion of the tape.

International audience; Carcinosarcomas are rare uterine cancers and carry poor prognosis. Although these tumours usually arise de novo, some cases developed under tamoxifen therapy have been reported. We report two more cases of uterine carcinosarcoma occurring in two postmenopausal patients benefiting from tamoxifen therapy as adjuvant treatment of breast cancer. A review of the literature is undertaken.

International audience; Rhabdomyosarcoma (RMS) of the uterine corpus is rare in adult females. This tumor can be encountered in two distinct histopathological contexts: usually as a component of a malignant mixed mullerian tumor and exceptionally as a pure heterologous sarcoma. We report two cases of pure RMS of the uterine corpus occurring in postmenopausal women. The two patients suffered from vaginal bleeding and preoperative diagnosis was achieved in both cases. Both patients benefited from exploratory laparotomy, total hysterectomy and bilateral salpingo-oophorectomy. Both of them were free from the disease 15 months and 1 year respectively, after initial surgery. These two observations are worthy of publication because pure RMS of the uterine corpus is exceptional in postmenopausal women.

International audience; A descriptive analysis of available data on reported cases of uterine carcinosarcomas associated with tamoxifen therapy is undertaken. The role of aromatase inhibitors as alternative to tamoxifen therapy in the adjuvant setting of breast cancer is discussed. The eventual implications of the presumed association of uterine carcinosarcoma and tamoxifen therapy on the choice of the therapeutic agent in the adjuvant setting of hormone-sensitive breast cancer are discussed.

Sarcoma of the uterus are rare uterine cancers with poor prognosis. They are characterised by pathological diversity and their symptomatology is not specific. The aim of this study was to review our experience with uterine sarcomas, to analyze their clinical and histopathological features, to discuss about diagnostic and therapeutic difficulties associated with these tumours and to compare our findings with previously published data.A retrospective review, from 1996 to 2005, of cases of uterine sarcomas diagnosed and treated at the department of obstetrics-gynaecology, Belfort Hospital. Clinical and pathological features, types of treatment, tumoral stage according to the FIGO histological classification and patients' outcome were recorded.From 1996 to 2005, 15 cases of uterine sarcomas have been diagnosed in our department. Our study included six histological types: carcinosarcoma (n=5), leiomyosarcoma (n=3), rhabdomyosarcoma (n=2), adenosarcoma (n=2), stromal sarcoma (n=2), and undifferentiated sarcoma (n=1). Patients' mean age at the time of diagnosis was 67.6 years (range: 48-91 years). Vaginal bleeding was the most common presenting symptom, being present in 10 patients (67%). The mean time from onset of symptomatology and pathological diagnosis of sarcoma was 17.1 weeks (range: one to 60 weeks). In 10 patients (67%), definitive diagnosis of sarcoma was achieved only after surgical specimen analysis and in only three of them (30%), physical examination combined with pelvic ultrasonography had suspected malignancy. Dilation and curettage was performed in nine patients and failed to rule out neoplasia in three cases (33.5%). Fourteen patients (93%) underwent surgery: total hysterectomy with bilateral salpingo-oophorectomy in all of them and pelvic lymphadenectomy in four of them. Eight patients were in FIGO stage I, one patient in stage II, three patients in stage III and two patients in stage IV. Six patients benefited from adjuvant treatment: external beam radiotherapy and brachytherapy in three cases, brachytherapy in one case and chemotherapy in two cases. At the time of analysis, four patients were lost to follow-up, four patients were dead and with an average follow-up of 25 months, seven patients had a favourable outcome.Uterine sarcomas are rare cancers with poor prognosis. Their symptomatology is non-specific and they are characterized by histopathological diversity. Early diagnosis is essential because patients' survival is correlated to tumour stage. However, preoperative diagnosis is often difficult and definitive diagnosis is frequently achieved after pathological analysis of hysterectomies specimens.

Malignant transformation of endometriosis is a rare event. The ovaries are the most common sites reported in the literature. Postmenopausal cancer arising in extragenital endometriosis is still more exceptional. Hormone replacement therapy and perhaps, to a lesser extent, Tamoxifen could be risk factors for the malignant transformation of endometriosis. We herein report the case of a patient who has developed, after 11 years of hormone replacement therapy, an extragenital endometrioid carcinoma in the vesico-uterine pouch.