Occasionally mesenchymal components of MMT exhibit patchy positive staining with antibodies to cytokeratin and EMA, but this staining is less intense than is observed in the epithelial component of the tumor. Myoglobin is the most specific marker of rhabdomyoblastic differentiation but is also less sensitive. Immunoreactivity with desmin or muscle specific actin is also indicative of rhabdomyosarcoma. Foci of chondrosarcomatous differentiation are positive for S-100 protein. The prognosis is extremely poor.
Metastases occur early.
Some studies suggest that having only homologous stroma elements have a slightly better prognosis than those with heterologous elements. Other studies suggest that there is no significant difference in prognosis. The prognosis is far more outweighed by the surgical pathological stage of disease and the stage is the single most significant prognostic factor. Positive peritoneal cytology is associated with unfavorable prognosis and shows extrauterine spread. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy is the treatment of choice.