A 54-year-old female patient presented with "irregular vaginal bleeding" in June 2021 without specific treatment. In November 2021, the patient visited our hospital with worsening vaginal bleeding symptoms for further treatment. She had menarche at the age of 14 years and menopause 6 years ago with previous cycles of 5-6 days/28 days with normal flow. No significant past or family history was reported. Vaginal examination showed a polypoid mass with a diameter of about 5 cm in the cervix and free parametrial tissue on both sides. Abdominal MRI showed that the cervix was obviously thickened, mainly on the posterior wall, with the thickest part being about 7.2 cm, and the lesion involved the upper vaginal segment downward. The myometrium is also obviously thickened. A vaginal tissue biopsy showed scattered heterogeneous cells, and combined with HE morphology and immunophenotype, mesenchymal-derived sarcoma was considered. The biopsy tissue tumor sample was small, so it was suggested to send further examination after complete excision for clarification. Immunohistochemistry of tumor cells was positive for EMA, P63, vimentin, desmin, SMA, Ki-67, ER, and caldesmon and negative for Ckpan (AE1/AE3), P40, actin, S100, MyoD1, myoglobin, and PR. In November 2021, she underwent "transabdominal tumor cytoreduction (total hysterectomy + right adnexal resection + greater omentectomy + pelvic lymph node [LN] dissection + para-aortic LN dissection) + pelvic adhesion release." When the uterus is cut open, a cervical tumor (5 cm x 4.5 cm x 4 cm) and uterine tumor (6.8 cm x 6 cm x 4 cm) were seen (Figure 1). Routine examination revealed the following diagnoses: (1) left internal iliac and foramen occulans LN 1/6, right deep femoral LN 1/10, and para-aortic LN 1/11, showing the characteristic of tumor metastasis from endometrial adenocarcinoma; (2) left external iliac LN 1, left total iliac LN 6, left deep femoral LN 5, right external iliac LN 1, right total iliac LN 3, and right internal iliac and foramen occulans LN 1, all showing reactive hyperplasia; and (3) large omentum, but did not show any cancer involvement. Postoperative pathological diagnoses are as follows: (1) the "body of the uterus" is a highly differentiated endometrioid adenocarcinoma (Figures 2D, F), infiltrating deep myometrium (> 1/2 layer), involving the cervical glands and interstitium, without definite nerve invasion or choroidal carcinoma embolism; immunohistochemistry is recommended for follow-up treatment. No definite tumor residue was seen in the vaginal section or the left and right parametrial sections. (2) No tumor involvement was seen in the right adnexa. The first supplementary report revealed a cervical tumor, combined with HE morphology and immunophenotype, and the lesion was consistent with carcinosarcoma (Figure 2B), a sarcomatous component with chondrogenic differentiation. Immunohistochemistry of tumor cells was positive for EMA (Figure 2C), S100, caldesmon, calponin, P16, MDM2, CDK4, CD99, ER, Brg-1 (SMARCA4), Ki67, CD10, and Fli-1 and negative for Ckpan (AE1/AE3), CK8/18, CK7, desmin, PAX-8, SMA, P40, actin, PR, NKX2.2, WT1, MyoD1, myogenin, SATB2, and ERG. The cervical and uterine body lesions were observed microscopically as two different tumor sites. Microscopically, endometrial adenocarcinoma and cervical carcinosarcoma collide at the cervix and show clear boundaries (Figures 2A, E, G, H). The FIGO stage was IIIc. Cycle 1 chemotherapy (paclitaxel 250 mg ivgtt d1 + carboplatin 500 mg ivgtt d1) was administered on 17 December 2021 and later administered doxorubicin 100 mg ivgtt d1 + carboplatin 300 mg ivgtt d1 in cycle 2 due to the patient's heavy treatment response. On 21 February 2022, the patient completed 28 external pelvic irradiation radiotherapy and 2 intracavitary backloading treatments. The patient continued with 3-6 cycles of chemotherapy (doxorubicin 100 mg ivgtt d1 + carboplatin 300 mg ivgtt d1). She remained healthy with no evidence of recurrence for 13 months after surgery.