Necrotizing fasciitis.
Two cases of necrotizing fasciitis, a disease poorly documented in the gynecologic literature because of its extreme rarity, are described. These are the only cases of this entity seen in our department during the last 24 years. Both patients underwent major surgical procedures for uterine stromal sarcoma and mixed mesodermal tumor. In both, the pathognomonic signs, undermining of the skin, and extensive necrosis of the subcutaneous tissue and the underlying fascia, were present. Later gangrene occurred, and both patients died. The literature is briefly reviewed, which emphasizes the importance of immediate surgery when the disease is recognized. The possibility is suggested that the development of such local processes in cases of mixed mesodermal tumor may be an immunologic reaction and the cultured organisms contaminants.