To investigate the sonographic and histopathological features of uterine carcinosarcoma, so as to improve the understanding of the disease.

Six cases of uterine endometrial carcinosarcoma confirmed by pathology at Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University from January 2009 to December 2018 were retrospectively analyzed.

All the six patients with uterine carcinosarcoma were postmenopausal women. The clinical manifestation was postmenopausal vaginal bleeding of different degrees. Ultrasonographic examination showed that the uterus increased in postmenopausal women. The sum of the three uterine diameters of the six patients was 132-248 mm, with an average of (199.7±36.8) mm. The echo of the uterine cavity was obviously thickened and polypoid, with heterogeneous medium high or low echo in the uterus. The maximum diameter was 14-81mm, with an average of (47.2±21.3) mm. The boundary of some tumors was clear, with a "bright edge" and irregular shape. The boundary between some tumors and the myometrium was not clear. The blood flow score was 4 points in three cases, 3 points in two, and 2 points in one. The arterial blood flow spectrum could be obtained in all cases (RI[resistance index]: 0.15-0.59). Pathological examination revealed three cases of moderately differentiated endometrial carcinosarcoma and three cases of poorly differentiated endometrial carcinosarcoma. Microscopic pathology showed abundant blood vessels in the tumor, and six cases were accompanied by myometrial invasion.

Uterine carcinosarcoma is mostly manifested as postmenopausal vaginal bleeding with large polypoid lesions. The presence of large supporting vessels at the base of the uterus often indicate myometrial invasion. Hysteroscopy can help achieve a pathological diagnosis.