Malignant Carcinosarcoma

Malignant carcinosarcoma is a rare, aggressive cancer that contains two kinds of cancer cells in the same tumor: (1) gland or surface-type cells (“carcinoma,” the epithelial part) and (2) connective-tissue-type cells (“sarcoma,” the mesenchymal part). In modern classifications, especially in the uterus, experts consider it a high-grade carcinoma that has changed (“metaplastic”) to include sarcomatous areas, rather than a “true” sarcoma. This view is based on how the tumor behaves, how it looks under the microscope, and what its genes show. PubMed Central+2PubMed Central+2

Although carcinosarcomas can arise in several organs, they most often occur in the uterus (endometrium) and behave like an aggressive form of endometrial cancer. They can also occur in the ovary, cervix, fallopian tube, and, rarely, in non-gynecologic sites such as the bladder, salivary glands, or lung. Cancer.gov+2Annals of Oncology+2

Malignant carcinosarcoma is a rare, aggressive cancer made of two kinds of malignant cells in the same tumor: a carcinoma part (from epithelial cells that line tissues) and a sarcoma part (from connective or supporting tissue). Because it behaves like a high-grade endometrial cancer and also like a soft-tissue sarcoma, it tends to spread early and needs prompt treatment with surgery and often chemotherapy and radiation. Doctors sometimes call uterine carcinosarcoma a “malignant mixed Müllerian tumor (MMMT).” Cancer.gov+2Cancer.gov+2

---

Other names

• Malignant mixed Müllerian tumor (MMMT) – an older, still common name in gynecologic oncology.

• Uterine carcinosarcoma (UCS) – when the tumor is in the uterus.

• Metaplastic carcinoma with sarcomatous differentiation – a descriptive term used by pathologists.
  These names refer to the same basic idea: a biphasic tumor with both carcinoma and sarcoma components. PubMed Central+1

---

Types

1) By where the tumor starts (site):

• Uterus (endometrium): most common and best studied.

• Ovary, cervix, fallopian tube: less common gynecologic sites.

• Extra-gynecologic sites: very rare (e.g., bladder, lung, salivary gland).
  Site matters because it guides the exam, imaging, and surgery. Cancer.gov+1

2) By the sarcoma part it contains:

• Homologous type: the sarcomatous part resembles tissues normally found in that organ (e.g., fibrous tissue, smooth muscle).

• Heterologous type: the sarcoma part shows tissues not normally found there (e.g., cartilage, skeletal muscle, bone).
  This split helps a pathologist describe the tumor in detail, though modern treatment focuses more on overall stage and high-grade behavior. PubMed Central

3) By microscopic pattern and markers:

1. Under the microscope, the epithelial (carcinoma) component can look like high-grade serous or high-grade endometrioid carcinoma. Immunostains such as p53 and p16 often support a high-grade pattern; the sarcoma areas may express vimentin, desmin, or myogenin when muscle-type changes are present. These help confirm the biphasic nature. Lippincott Journals+2Pathology & Oncology Research+2

4) By molecular/genetic profile:

1. Common tumor gene changes include TP53 and frequent alterations in the PI3K pathway (e.g., PIK3CA, PTEN) and other drivers like FBXW7 and PPP2R1A—patterns that overlap with aggressive endometrial carcinomas. This supports the idea that carcinosarcoma behaves as a high-grade carcinoma with mesenchymal transformation. pnas.org+2ResearchGate+2

---

Causes and risk factors

Carcinosarcoma does not have a single cause. Instead, several risk factors increase the chance of developing it—most of them are the same as for high-grade endometrial cancer.

1. Older age: risk rises in the 60s–70s; the disease is more common after menopause. Aging cells collect genetic damage over time. JGO Journal of Gynecologic Oncology

2. Prior pelvic radiation: radiation can injure DNA in uterine cells; very rarely, a cancer appears years later. JGO Journal of Gynecologic Oncology

3. Long-term tamoxifen use: tamoxifen (used for breast cancer) can act like estrogen in the uterus, increasing risk in some women. OUP Academic

4. Excess estrogen exposure (unopposed estrogen): estrogen without enough progesterone stimulation (e.g., postmenopausal estrogen therapy without progestin) can drive endometrial growth and mutations. NCBI

5. Obesity: fat tissue converts hormones into estrogen; higher estrogen levels can stimulate the endometrium. BMJ Open

6. Metabolic syndrome (obesity with high blood pressure, high sugar, abnormal lipids): long-term inflammation and hormone changes may increase uterine cancer risk. SpringerLink

7. Nulliparity (never having given birth): more menstrual cycles over a lifetime means more estrogen exposure to the uterine lining. NCBI

8. Infertility or chronic anovulation: fewer progesterone-balanced cycles may leave estrogen effects unchecked. NCBI

9. Diabetes: metabolic and hormonal shifts can add risk beyond weight alone. NCBI

10. Hypertension: often travels with obesity and diabetes; may mark higher overall risk. NCBI

11. Genetic instability in tumor cells (especially TP53 mutations): these mutations are common in carcinosarcoma and help the carcinoma behave more aggressively. pnas.org

12. PI3K pathway alterations (PIK3CA, PTEN): these signal pathways control growth; when altered, cells divide faster and resist cell death. ResearchGate

13. FBXW7 / PPP2R1A alterations: these changes also push growth and genomic instability in high-grade endometrial tumors, including carcinosarcoma. Hematology and Oncology

14. Prior breast cancer with anti-estrogen therapy history: some survivors have combined hormone and treatment exposures that may raise uterine cancer risk. SpringerLink

15. Racial and ethnic disparities (e.g., higher incidence and worse outcomes in Black women): differences likely arise from combined biology, access, and social factors. JGO Journal of Gynecologic Oncology

16. Endometrial carcinoma background: carcinosarcoma often arises from an existing high-grade endometrial carcinoma that “transforms” into sarcomatous areas. Gynecological Cancer Journal

17. Chronic endometrial injury/inflammation: long-standing tissue stress can promote genetic errors over time (inference consistent with high-grade EC biology). Annals of Oncology

18. Hormone-producing ovarian tumors or exogenous sources: rarely, extra estrogen sources can stimulate the uterus continuously. NCBI

19. Rare hereditary cancer syndromes: unlike typical endometrial cancers, clear links are weaker here, but some syndromes can still raise uterine cancer risks overall. NCBI

20. General carcinogen exposure and aging DNA repair decline: as with many cancers, time and environmental hits allow driver mutations to accumulate. Annals of Oncology

---

Common symptoms

1. Postmenopausal bleeding: the most frequent warning sign; any bleeding after menopause needs medical review. Cancer.gov

2. Irregular or heavy periods (if not yet menopausal): unusual bleeding suggests endometrial overgrowth or tumor irritation. Cancer.gov

3. Watery or blood-stained vaginal discharge: tumor surfaces can ooze fluid or blood. Cancer.gov

4. Pelvic or lower abdominal pain/pressure: a growing mass can stretch or press on nearby structures. Cancer.gov

5. Pelvic fullness or a palpable mass: some patients feel heaviness or notice a mass during exam. Cancer.gov

6. Pain with intercourse: tumor-related inflammation can make contact painful. Cancer.gov

7. Unintended weight loss: advanced cancers often cause systemic weight loss. Cancer.gov

8. Fatigue and weakness: chronic bleeding or cancer-related inflammation can cause anemia and tiredness. Cancer.gov

9. Bloating or abdominal distension: spread to the peritoneum or ovaries can produce fluid or bulk symptoms. Cancer.gov

10. Changes in urination (frequency, urgency): a uterine mass can press on the bladder. Cancer.gov

11. Constipation or rectal pressure: the mass can press on the rectum. Cancer.gov

12. Back or hip pain: local invasion or lymph node enlargement may refer pain. Cancer.gov

13. Swollen legs (lymphedema): lymph node involvement or pelvic compression can impair drainage. Cancer.gov

14. Shortness of breath or cough (rare, with lung spread): advanced disease can metastasize to the lungs. Cancer.gov

15. No symptoms at first: early disease can be silent; bleeding is often the first clue. Cancer.gov

---

Diagnostic tests

A) Physical examination

1. General medical exam: checks overall condition, weight changes, anemia signs, and other illnesses that may affect treatment. Cancer.gov

2. Abdominal exam: looks for tenderness, masses, or fluid (ascites) that might suggest spread. Cancer.gov

3. Pelvic speculum exam: visualizes the vagina and cervix to see bleeding source and rule out cervical lesions. Cancer.gov

4. Bimanual pelvic exam: the clinician feels the uterus and adnexa for size, mobility, and masses. Cancer.gov

5. Rectovaginal exam: assesses tissue behind the uterus and nearby ligaments for nodules or fixation. Cancer.gov

B) “Manual” or office-based procedural tests

6. Endometrial biopsy (pipelle): a thin tube samples the uterine lining; often confirms a high-grade carcinoma and may show sarcomatous elements. If sarcoma component is not captured, final diagnosis is made on hysterectomy. Cancer.gov

7. Hysteroscopy with directed biopsy: a camera inside the uterus helps the doctor see and target abnormal areas if office biopsy is inconclusive. Cancer.gov

8. Cervical cytology/HPV testing (context-dependent): not a test for carcinosarcoma itself, but helps rule out cervical sources of bleeding or combined pathologies. Cancer.gov

C) Laboratory and pathological tests

9. Complete blood count (CBC): looks for anemia from bleeding and baseline health status. Cancer.gov

10. Basic metabolic and liver panels: check organ function to plan imaging, surgery, and chemotherapy. Cancer.gov

11. Tumor markers (e.g., CA-125): may be elevated, especially with extra-uterine spread, but are not diagnostic alone. Cancer.gov

12. Definitive histopathology of the uterus/tumor: after surgery (or large biopsy), the pathologist confirms the biphasic pattern—carcinoma plus sarcoma—and reports whether sarcoma is homologous or heterologous. This is the gold standard. PubMed Central

13. Immunohistochemistry (IHC): stains such as p53, p16 (often abnormal in high-grade components), cytokeratins (epithelial), vimentin/desmin/myogenin (mesenchymal) help prove both components and exclude look-alikes. Lippincott Journals+1

14. Molecular testing (when available): may show TP53, PIK3CA, PTEN, FBXW7, PPP2R1A changes; this supports classification and can guide trials. pnas.org

15. MMR (mismatch repair) and POLE testing (selected cases): mainly for endometrial cancers; less often positive in carcinosarcoma, but sometimes done to fully subtype the carcinoma part. Annals of Oncology

D) Electrodiagnostic tests

Note: There are no electrodiagnostic tests that diagnose carcinosarcoma itself. These are used only if symptoms suggest specific organ problems.

16. Electrocardiogram (ECG): performed to prepare safely for anesthesia and surgery or anthracycline-based chemotherapy; it checks heart rhythm and prior heart disease. (Peri-operative/oncology standard practice.)

17. EEG or nerve studies (rare, symptom-driven): only if there are neurologic symptoms (e.g., seizures, neuropathy) suggesting brain or nerve involvement; these do not diagnose the tumor but evaluate complications. (General oncology practice.)

E) Imaging tests

18. Transvaginal and transabdominal ultrasound: first-line imaging for abnormal bleeding; looks at endometrial thickness and masses. Cancer.gov

19. Pelvic MRI: best anatomic picture of the uterus and local spread (myometrium, cervix, parametrium); helps surgical planning. Annals of Oncology

20. CT of chest/abdomen/pelvis: checks lymph nodes and distant spread (lungs, peritoneum); widely used for staging and follow-up. PET/CT may be added in selected cases to assess metabolic activity and hidden metastases. Cancer.gov

Non-pharmacological (non-drug) treatments

Each item includes what it is, why it’s used, and how it works.

1. Specialist surgical oncology care and tumor board review
   Care at centers with gynecologic oncology and sarcoma expertise helps choose the right order of surgery, chemo, and radiation. A multidisciplinary tumor board aligns pathology, imaging, surgery, medical oncology, radiation, and nutrition to individualize care and reduce delays. PubMed+1

2. Definitive surgery when resectable
   When possible, removing all visible disease first gives the best chance of long-term control. Standard operations for uterine disease include total hysterectomy with both ovaries and tubes removed, with selective lymph nodes and omentum assessed; “debulking” (cytoreduction) may be used for spread. Cancer.gov+1

3. Enhanced Recovery After Surgery (ERAS) pathways
   Structured pre-op counseling, nutrition, early mobilization, and standardized pain control shorten hospital stay, reduce complications, and help patients start adjuvant therapy sooner, which may improve outcomes. ESPEN

4. Pathology and molecular testing quality control
   Accurate diagnosis (confirming biphasic carcinoma+sarcoma) and checking for mismatch-repair deficiency (dMMR/MSI-H) or other markers guide chemotherapy and eligibility for immunotherapy. Cancer.gov

5. Pelvic radiation (as indicated) for local control
   External-beam and/or brachytherapy can lower pelvic recurrence after surgery in selected patients; it is planned by a radiation oncologist using imaging to target tumor beds and protect normal organs. Cancer.gov

6. Cancer pain management using the WHO ladder
   Start with non-opioids, escalate to weak then strong opioids as needed, and add adjuvants (e.g., nerve-targeted medicines). Following this ladder improves pain, function, and quality of life while limiting harm. World Health Organization+1

7. Exercise therapy (aerobic + resistance), tailored to fatigue level
   Regular, supervised activity during and after treatment reduces fatigue, preserves muscle and mood, and can improve surgical readiness and long-term health; oncology guidelines now recommend this routinely. ASCO Publications

8. Nutrition therapy and early dietitian support
   Screen for weight loss and poor intake; use high-protein meals, oral nutrition supplements, or tube/IV feeding when indicated to prevent malnutrition and help tolerate therapy. Follow ESPEN’s practical algorithms. ESPEN+1

9. Cachexia management (multimodal)
   Treat reversible causes of low appetite, consider structured exercise and diet support, and use brief counseling for goals of care; drug options are limited and evidence for supplements is modest. ASCO Publications+1

10. Psychosocial and psycho-oncology care
    Simple, structured counseling and peer support lower anxiety and depression, improve treatment adherence, and help families cope during long treatments. PubMed Central

11. Lymphedema prevention and therapy
    After nodal surgery or radiation, early education, compression, and manual lymphatic drainage can reduce swelling and disability; evidence supports added benefit over compression alone in some settings. Cochrane Library+1

12. Smoking cessation
    Stopping tobacco before and during treatment lowers wound problems, lung issues, and second cancer risk; brief clinician advice plus nicotine replacement or counseling has the best effect. ASCO Publications

13. VTE (blood clot) prevention strategy
    Use risk scoring and mechanical or pharmacologic prophylaxis around surgery/chemo, following ASCO’s updated guidance to cut deep vein thrombosis and pulmonary embolism risk. ASCO Publications+1

14. Sexual health care
    Address vaginal dryness, pain, and body-image concerns after surgery or radiation using moisturizers, dilators, pelvic-floor therapy, and counseling to restore comfort and intimacy. Cancer.gov

15. Fertility and endocrine counseling (when relevant)
    Before treatment, discuss fertility loss and hormone effects; consider tissue/egg preservation if time and situation allow, and plan safe hormone strategies post-treatment as appropriate. ESGO

16. Anemia and fatigue clinics
    Screen for iron deficiency, blood loss, and marrow suppression; correct reversible causes to improve energy and readiness for treatment cycles. Cancer.gov

17. Infection prevention education
    Hand hygiene, food safety, oral care, and prompt fever reporting reduce severe infections during chemotherapy-related neutropenia. Cancer.gov

18. Palliative care early integration
    Symptom control, decision support, and family coaching started early—not only at end-of-life—improves quality of life and, in some cancers, survival. World Health Organization

19. Return-to-activity planning
    Simple, written activity plans (walking goals, light strength work) maintain function and mood and help transition after therapy. ASCO Publications

20. Long-term lifestyle plan (weight, diet, and movement)
    A heart-healthy pattern (vegetables, fruits, whole grains, lean proteins) and 150–300 minutes/week of activity supports general cancer prevention and survivorship health. ASCO Publications+1

---

Drug treatments

Important notes: (1) Many drugs below are standard in uterine carcinosarcoma even when the FDA label’s formal indication is for other cancers—that is called off-label use and is driven by high-quality trials and guidelines; (2) actual choices depend on stage, performance status, prior therapy, pathology, and molecular markers; (3) doses vary—follow label and protocol specifics.

1. Paclitaxel (taxane)
   Used with carboplatin as the preferred first-line regimen for uterine carcinosarcoma; stabilizes microtubules to stop cell division. The GOG/NRG phase III trial showed carboplatin-paclitaxel is non-inferior to ifosfamide-paclitaxel for overall survival with better progression-free survival and less toxicity, making it the modern standard. Label warns of neutropenia and hypersensitivity; typical schedules are every 3 weeks. PubMed Central+2ASCO Publications+2

2. Carboplatin (platinum)
   Pairs with paclitaxel; causes DNA crosslinks that kill rapidly dividing cells. Chosen for efficacy and a more manageable safety profile versus cisplatin in many gynecologic protocols; label notes myelosuppression and hypersensitivity. Dosed by AUC (Calvert formula). PubMed Central+2FDA Access Data+2

3. Ifosfamide + Mesna (alkylator + uroprotection)
   An older backbone for carcinosarcoma (often with paclitaxel), now largely replaced by carbo-taxol for many patients; ifosfamide crosslinks DNA, while mesna protects the bladder. Neurotoxicity and myelosuppression are key risks; careful hydration and monitoring are required. PubMed Central+2FDA Access Data+2

4. Doxorubicin (anthracycline)
   An option in selected settings or combinations; intercalates DNA and inhibits topoisomerase II. Labels highlight cardiotoxicity risk and lifetime dose limits, so baseline and periodic heart checks are standard. FDA Access Data+1

5. Cisplatin (platinum)
   Active against many gynecologic tumors; compared with carboplatin it may have more kidney and nerve toxicity, so hydration and renal monitoring are essential. Used when specific protocol or prior therapy favors it. FDA Access Data+1

6. Docetaxel (taxane alternative)
   Sometimes substituted for paclitaxel in intolerance or neuropathy; acts on microtubules and causes neutropenia and fluid retention per label. (Docetaxel may be used off-label for UCS based on clinician judgment.) Cancer.gov

7. Gemcitabine (antimetabolite)
   Occasionally used in recurrent disease or combined with other agents; inhibits DNA synthesis and is scheduled weekly in many protocols. Label notes myelosuppression and transaminitis. (Used off-label in UCS.) Cancer.gov

8. Bevacizumab (anti-VEGF monoclonal antibody)
   Sometimes added in recurrence settings to limit tumor blood supply; risks include hypertension, bleeding, and impaired wound healing, so it is avoided close to major surgery. Indications are cancer-type specific on label; use in UCS is individualized. FDA Access Data+1

9. Pembrolizumab (PD-1 inhibitor; tissue-agnostic approvals)
   For MSI-H/dMMR or TMB-high solid tumors after prior therapy, pembrolizumab can be used regardless of the original tumor site; in endometrial cancer it also has label updates and combinations. Immune-related side effects (thyroiditis, colitis, hepatitis) require monitoring. Testing tumors for dMMR/MSI guides this choice. FDA Access Data+1

10. Dostarlimab (PD-1 inhibitor)
    Approved for dMMR recurrent or advanced endometrial cancer and, more recently, in combination with carboplatin/paclitaxel followed by maintenance in dMMR primary advanced/recurrent disease; immune-related adverse events resemble pembrolizumab. For a carcinosarcoma with dMMR features, clinicians may consider this path. FDA Access Data+2FDA Access Data+2

Why carbo-taxol first? The randomized GOG/NRG 0261 trial directly in uterine carcinosarcoma found paclitaxel+carboplatin non-inferior for overall survival, better for progression-free survival, and less toxic than ifosfamide+paclitaxel—so many centers now prefer carbo-taxol up front. PubMed Central+2ASCO Publications+2

---

Core surgeries

1) Total hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO)
Removal of uterus, cervix, tubes, and ovaries is the most common definitive operation when disease is confined to the uterus or resectable; it removes the primary tumor and potential hormone sources. American Cancer Society

2) Surgical staging with selective lymph node assessment
Pelvic and sometimes para-aortic nodes are sampled or removed to check spread and guide decisions on radiation and chemotherapy; some studies suggest a survival benefit in selected patients. American Cancer Society+1

3) Omentectomy and peritoneal biopsies
Because spread can occur to the omentum and peritoneum, surgeons may remove involved omentum and take biopsies to improve staging accuracy and clear visible disease. Cancer.gov

4) Cytoreductive (debulking) surgery for advanced disease
When the cancer has spread within the abdomen, surgeons aim to remove as much tumor as safely possible to enhance the effect of chemotherapy and improve symptoms. Cancer.gov

5) Radical/pelvic exenteration (rare, highly selected)
Extremely extensive surgery can be considered for central pelvic recurrences without distant spread when other options are not feasible; decisions are individualized at expert centers. ESGO

---

Prevention and risk reduction

There is no guaranteed way to prevent carcinosarcoma, but reducing overall endometrial cancer risks helps. Healthy body weight, control of diabetes, and avoiding long-term unopposed estrogen lower risk; discuss risks of tamoxifen with your care team and report any abnormal bleeding; pelvic radiation for other cancers slightly raises future uterine sarcoma risk. People with Lynch syndrome need tailored counseling and may consider risk-reducing surgery after childbearing. PeaceHealth+4American Cancer Society+4Cancer.gov+4

---

When to see a doctor

See a clinician urgently for post-menopausal bleeding, new or persistent vaginal bleeding or watery discharge, pelvic pain or pressure, rapidly enlarging abdominal girth, shortness of breath, or sudden leg swelling/pain (possible blood clot). These warning signs need evaluation with pelvic exam and imaging/biopsy. Cancer.gov

---

Diet: what to eat and what to avoid

What to eat: Choose small, frequent, high-protein meals (eggs, fish, legumes, yogurt), soft textures during chemo, and energy-dense snacks if weight loss is a problem; use prescribed oral nutrition supplements if appetite is low. Prioritize fruits, vegetables, whole grains, and healthy fats for long-term heart and metabolic health. Work with a dietitian early. ESPEN

What to avoid or limit: Skip unpasteurized foods and undercooked meats during neutropenia; avoid high-dose antioxidant supplements that may interact with treatment unless your oncology team advises them; limit alcohol, and avoid herbal products that affect bleeding or liver enzymes unless reviewed by your doctor. ESPEN

---

FAQs

1) Is carcinosarcoma the same as endometrial cancer?
It is a distinct type that contains both carcinoma and sarcoma parts; it is usually treated like a very high-risk endometrial cancer with sarcoma features. Cancer.gov

2) What is first-line chemotherapy today?
Most patients receive carboplatin + paclitaxel based on a large randomized trial showing equal or better outcomes and less toxicity than ifosfamide-based therapy. PubMed Central

3) Will I need radiation after surgery?
Some patients do, to lower pelvic recurrence risk; your team decides using stage, margins, lymph nodes, and other risk features. Cancer.gov

4) Do immunotherapy drugs work here?
If the tumor is dMMR/MSI-H, PD-1 inhibitors like pembrolizumab or dostarlimab can be used; testing the tumor is key. FDA Access Data+1

5) Are there proven supplements that treat carcinosarcoma?
No supplement treats this cancer. Nutrition support is important, but follow guideline-based care and avoid unproven products that can interfere with therapy. ESPEN

6) Can exercise really help?
Yes—supervised aerobic and resistance exercise reduces fatigue and improves function during and after treatment; major oncology groups recommend it. ASCO Publications

7) Why is pathology review important?
Confirming the mixed components and checking markers like dMMR changes treatment choices (for example, immunotherapy eligibility). Cancer.gov

8) What side effects matter most with chemo?
Low blood counts, infection risk, neuropathy, hair loss, and fatigue are common; platinum drugs can affect kidneys/ears, anthracyclines the heart, and ifosfamide the nerves and bladder—teams monitor and prevent these. FDA Access Data+2FDA Access Data+2

9) Is lymph-node surgery always needed?
Not always, but selective nodal assessment helps staging and may improve outcomes in some series; decisions are individualized. PubMed

10) What if surgery isn’t possible first?
Neoadjuvant chemotherapy or chemoradiation may shrink disease to allow surgery later; this is decided at expert centers. ESGO

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: November 10, 2025.

PDF Documents For This Disease Condition References