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PubMed1999

[A case of true carcinosarcoma in bladder diverticulum].

We report a case of carcinosarcoma arising from a bladder diverticulum. A 71-year-old male was referred to our hospital for macroscopic hematuria. Two diverticula were identified in the left wall of the urinary bladder, one of which showed a broad-based tumor. The bladder tumor was resected using a transuretheral approach and the tumor was histologically diagnosed as leiomyosarcoma. The patient underwent partial resection of the bladder including the two diverticula and the tumor. Pathological examination revealed that the resected specimen was composed of three elements, transitional cell carcinoma (G3), squamous cell carcinoma, and leiomyosarcoma. Thus, the patient was diagnosed with carcinosarcoma. He died 5 months after surgery to remove the panperitonitis carcinomatosa. This case is the 38th reported case of bladder carcinosarcoma in Japan.

Aged↗

PubMed2000

Frequent genetic heterogeneity in the clonal evolution of gynecological carcinosarcoma and its influence on phenotypic diversity.

Carcinosarcomas of the uterus, ovaries, and fallopian tubes are highly aggressive neoplasms with incompletely understood histogenesis. Although recent immunohistochemical, cell culture, and molecular genetic studies all favor these cancers to be monoclonal in origin, the extent of intratumoral genetic heterogeneity in these tumors with divergent histology has not been reported previously. For this study, we microdissected a total of 172 carcinomatous or sarcomatous foci from 17 gynecological carcinosarcomas and analyzed allelic status with 41 microsatellite markers on chromosomal arms 1p, 1q, 3p, 4q, 5q, 6q, 8p, 9p, 10q, 11p, 11q, 13q, 16q, 17p, 17q, 18q, and 22q. With the exception of a single case with microsatellite instability, we found shared allelic losses and retentions among multiple individually dissected foci of each case, strongly supportive of the concept of a monoclonal origin for these neoplasms. In eight of these cases, we also found heterogeneous patterns of allelic loss at limited numbers of chromosomal loci in either the carcinomatous or sarcomatous components of the neoplasms. These heterogeneous patterns of allelic losses were consistent with either genetic progression or genetic diversion occurring during the clonal evolution of these neoplasms. In two cases, we found the specific patterns of genetic progression to be consistent with sarcomatous components of the neoplasms arising from carcinomatous components. We conclude that most of the gynecological carcinosarcomas have a monoclonal origin, and that genetic progression and diversion parallel the development of divergent phenotypes in these tumors. Because phenotypically divergent areas of the tumors share numerous genetic alterations, this divergence most likely occurs relatively late in the evolution of these tumors.

Carcinosarcoma↗

PubMed1999

[Chemotherapy in the treatment of ovarian carcinosarcoma].

Carcinosarcoma of the ovary is a rare neoplasm representing 1% of this organ malignancies. The disease appears almost exclusively in advanced stage having an unfavourable prognosis. Three patients affected by carcinosarcoma (MMMT) of the ovary admitted to our Operative Unit have been treated. All patients underwent surgery and subsequently chemotherapy. Two patients were affected by heterologous MMMT and were stage IV and IIIc respectively, the other one, affected by homologous MMMT, was stage IIIc. Stage IV patient was submitted to 6 cycles of CARBO + IFX + CDDP, second look and further 6 cycles of TAX. After 23 months she was submitted to colostomy for intestine occlusion. At the 35 months she died for cachexia and intestine occlusion. Stage IIIc heterologous patient was submitted to 6 cycles of CDDP + EPI + IFX + MESNA for 3 days; at 6 months from diagnosis she did not present any sign of disease. Stage IIIc homologous patient, affected by chronic renal insufficiency and submitted to dialysis, underwent 5 cycles of TAX and at 11 months from diagnosis presented partial response. Carcinosarcoma of the ovary, because of its rarity, and of the poor record of cases in the literature, is a much debated topic in particularitis complementary therapy. Opinions of the several authors are in contrast regarding the use of CHT + RT at the same time. Only RT after surgery does not seem to improve the survival of these patients. Personal experience, with the reported outlines, compared with survival, seems to confirm the use of CDDP and of IFX and to give new horizons to TAX, waiting for further findings.

Antineoplastic Agents, Alkylating↗

PubMedDate not supplied

TNP-470 inhibits growth and the production of vascular endothelial growth factor of uterine carcinosarcoma cells in vitro.

BACKGROUND: Carcinosarcoma is the most aggressive neoplasm among the known uterine malignancies. Most patients who are affected with this biphasic neoplasm hardly show any response to common anti-cancer drugs or radiotherapy and thus they tend to show an extremely poor prognosis. This is the first study to examine the inhibitory and anti-angiogenic effects of angiogenesis inhibitor TNP-470, a synthetic analogue of fumagillin, for human uterine carcinosarcoma in vitro. MATERIALS AND METHODS: The direct growth-inhibitory effect of TNP-470 was examined by an MTT assay in vitro. The levels of vascular endothelial growth factor (VEGF) in the culture supernate of TNP-470 treated FU-MMT-1 cells were also analyzed by an enzyme-linked immunosorbent assay (ELISA). The VEGF expression of TNP-470 treated FU-MMT-1 cells was also immunohistochemically examined using an anti-VEGF antibody. RESULTS: TNP-470 inhibited the growth of FU-MMT-1 cells in vitro. The level of VEGF in the culture supernatant of TNP-470 treated FU-MMT-1 cells was significantly lower than that of the control (TNP-470 untreated FU-MMT-1 cells) in vivo. The expression of VEGF in TNP-470 treated FU-MMT-1 cells immunocytochemically decreased in comparison to that of the control TNP-470 untreated FU-MMT-1 cells). CONCLUSIONS: Our in vitro findings suggest that this angiogenesis inhibitor, TNP-470, might be a novel therapeutic agent for uterine carcinosarcoma. However, further in vivo experimental studies using TNP-470 for this tumor will be necessary before any definitive conclusions can be made.

Antibiotics, Antineoplastic↗

PubMed1997

Carcinosarcoma of the submandibular and sublingual salivary glands. A case report and review of the literature.

Carcinosarcoma of the salivary gland is a rare lesion, estimated at 0.2% of malignant salivary gland tumors [1, 2]. The present article describes a case occurring in a 54-year-old man with a submandibular mass in the right neck. Histologically, this lesion was a carcinosarcoma which involves the submandibular and the sublingual glands. Its stromal component was a chondrosarcoma and the epithelial one was an undifferentiated carcinoma in the whole tumor, with areas of adenoid cystic carcinoma in the sublingual gland. To our knowledge, we have not found any previously reported carcinosarcoma involving the sublingual gland.

Carcinoma↗

PubMed2002

[A case of advanced ovarian carcinosarcoma that responded remarkably to neoadjuvant chemotherapy of combined CPT-11 and CDDP].

Carcinosarcoma of the ovary is a very rare and highly malignant neoplasm that accounts for less than 1% of ovarian neoplasms. Survival of patients with advanced stage cancer is poor and the best treatment is not clear. We report the case of a 60-year-old woman who had Stage IV advanced heterogeneous ovarian carcinosarcoma with lung and liver metastases. The lesions were considered surgically incurable, so she was placed on neoadjuvant chemotherapy of combination CPT-11 (60 mg/m2, day 1, 15) and CDDP (60 mg/m2, day 1). Tumor markers of CA125 and LDH decreased remarkably to the normal level after 3 and 4 courses of chemotherapy, respectively. After 7 courses of chemotherapy, the ovarian tumor was obviously reduced, and the lung and liver metastases had disappeared. The patient was then able to undergo surgery. The current case suggests that combination CPT-11 and CDDP is effective against advanced ovarian carcinosarcoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2003

Carcinosarcoma of the breast: report of two cases.

Carcinosarcoma is a rare, malignant tumor of the breast, consisting of intraductal or infiltrating carcinoma contiguous or subtly merged with a highly cellular, mitotically active pleomorphic spindle cell stroma (sarcoma). It is a form of the metaplastic mammary carcinomas and it is probably derived of myoepithelial cells. We report two cases of breast carcinosarcoma in two white women. The patients, following a frozen section positive for malignancy, had had a modified radical mastectomy. Paraffin sections and positive immunohistochemical cell staining (in our first case) confirmed the diagnosis of carcinosarcoma. This tumor should be distinguished from other forms of metaplastic carcinomas because it is very aggressive and has an ominous prognosis.

Adult↗

PubMed1992

[Carcinosarcoma of the prostate. Immunophenotype, morphologic course and clinico-pathologic differential diagnosis].

The observation of a patient with a malignant tumor of the prostate initially classified as adenocarcinoma with desmoplasia, reclassified as adenocarcinoma with a malignant spindle cell component of uncertain cell line following two large tumor recurrences over a period of 4 months, and subsequently as carcinosarcoma with heterologous mesenchymal areas has prompted us to review the 11 reported cases of prostatic carcinosarcoma and the diagnostic algorithm of the proliferative processes of the prostate with elongated cells in order to recognize (from the histological features and the inclusion and exclusion immunophenotypes) the pseudosarcomatous stromal reactions, fusicellular changes of the carcinoma, benign and malignant phyllodes tumors and carcinosarcoma.

Adenocarcinoma↗

PubMed1992

Carcinosarcoma of esophagus. Report of one case and review of the literature.

Esophageal carcinosarcoma is a rare malignant tumor. The tumor is composed of both carcinomatous and sarcomatous elements. The multiple designations of names such as pseudosarcoma, pseudosarcomatous carcinoma, polypoid carcinoma etc. reflect the controversy on the nature of sarcomatous component of this lesion. We report a case of carcinosarcoma of esophagus occurred in a 67 year old male with progressive dysphagia. Esophageal polypoid tumor was found by endoscopy and was resected by esophagectomy. Carcinosarcoma was proved by demonstrating both carcinomatous and sarcomatous components in the tumor. Immunohistochemical studies revealed positive keratin stain in the sarcomatous area and positive vimentin stain in the sarcomatous area. The tumor was reported to have a better prognosis than that of the squamous cell carcinoma of esophagus in the literatures, especially in the survival rate.

Aged↗

PubMed2004

Recurrent carcinosarcoma of the renal pelvis. Case report.

Carcinosarcoma is a malignancy that occurs very rarely in the renal pelvis; thus, only a very limited number of cases has been documented. These tumors are composed of both carcinomatous and sarcomatous elements. We report here a case of a carcinosarcoma composed of well-differentiated, keratinizing, squamous carcinoma cells and high-grade sarcoma cells. Differently from the cases described so far, this carcinosarcoma of the renal pelvis was characterized by the quick recurrence, following complete surgical resection, as a highly disseminated high-grade sarcoma.

Carcinosarcoma↗

PubMed2004

Carcinosarcoma of the maxilla in a squirrel monkey (Saimiri sciureus).

We present the first, to our knowledge, described case of carcinosarcoma of the maxilla in a squirrel monkey. Carcinosarcomas are rare tumors of the upper aerodigestive tract, and consist of carcinomatous and sarcomatous tissue. Histologic analysis revealed a neoplasm composed of an adenocarcinomatous component (epithelial element) and a mesenchymal component (sarcomatous element). Metastatic growth was documented in the lung tissue and the submandibular lymph node. The histolopathologic findings, the pattern of metastasis, and the clinical progression closely resembled those of carcinosarcoma involving salivary glands in humans.

Animals↗

PubMed2003

Carcinosarcoma of the larynx.

Carcinosarcoma is a rare laryngeal malignance. A case of laryngeal carcinosarcoma in a 77-year-old patient is presented. Diagnostic difficulties, histopatology and immunohistochemistry features results are reviewed. Clinical course and therapy in laryngeal carcinosarcoma are described.

Aged↗

PubMed2004

Primary ovarian carcinosarcoma: a case report and review of the literature.

Primary ovarian carcinosarcoma is characterized by an admixture of malignant epithelial and stromal elements. This neoplasm is extremely rare with fewer than 400 cases reported in the English literature. Its histogenesis, clinical features and optimal treatment remain unclear because of the rarity of primary ovarian carcinosarcoma. This study focuses on the clinical, pathological, immunohistochemical features and survival of a 73-year-old patient with primary ovarian carcinocarcoma. The patient was treated with surgery followed by combined chemotherapy with carboplatin and taxol and assigned to FIGO Stage IIIc. She died from the disease 17 months after surgery. In conclusion, ovarian carcinosarcoma is a very aggressive tumor, especially when it is diagnosed at advanced stage.

Aged↗

PubMedDate not supplied

Carcinosarcomas--a retrospective analysis of 21 patients.

BACKGROUND: Carcinosarcomas (CS) are mixed epithelial and stromal tumours with both components being malignant. Twenty-one patients with carcinosarcomas who were treated at the University of Saarland, Germany, are presented. PATIENTS AND METHODS: The hospital records of all patients were reviewed. RESULTS: The mean age range for homologue CS (homCS) was 60.7 years and for heterologue CS (hetCS) 68.4 years. Post-menopausal bleeding and abdominal pain were the main symptoms. Treatment modalities included surgery, adjuvant radiation therapy and various chemotherapy regimens. The median follow-up time was 17.6 months (homCS) and 31.1 months (hetCS). The 1-year survival rate was 55.6% (hetCS 58.3%) and the 5-year survival rate was 11.1% (hetCS 8.3%). CONCLUSION: Carcinosarcoma is a uterine sarcoma with a poor prognosis. Treatment includes surgery and adjuvant chemotherapy, whereas radiotherapy does not necessarily lead to a benefit. Treatment with trastuzumab might be a new approach in the therapy of HER-2/neu-positive CS.

Aged↗

PubMed1976

C-type virus particles in urethan-induced pulmonary and renal carcinomas, in cell-graft-transmitted carcinosarcomas, and in filtrate-induced lymphomas in mice.

Repeated injections of urethan into suckling BALB/c mice induced multiple papillary adenocarcinomas in the lungs and kidneys. When the pulmonary tumors were transplanted i.p. by cell graft into 6 suckling BALB/c mice, they induced disseminated carcinosarcomas within the peritoneal cavity in all inoculated animals. Tumors resulting from the transplantation of tumor cells were used for preparation of filtered extracts. The filtrates were inoculated into 6 suckling BALB/c mice and induced generalized malignant lymphomas in all animals. The primary urethan-induced pulmonary and renal tumors, the carcinosarcomas that resulted from i.p. cell transfer, and also the generalized malignant lymphomas induced by inoculation of filtered extracts contained C-type virus particles. Theoretically, it could be assumed that both the primary urethan-induced pulmonary and renal tumors, as well as the cell-graft-induced peritoneal carcinosarcomas, contained the C-type virus particles as passengers, not necessarily related etiologically to the tumors in which they were found. It is quite likely, however, that these virus particles were etiologically related to the filtrate-induced malignant lymphomas in which they were also found.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

[Carcinosarcoma and papillary transitional cell carcinoma coexisting in the same bladder].

A case of synchronically coexistent carcinosarcoma and transitional cell carcinoma, with separate neoplastic processes in the same urinary bladder is presented. This tumour association is as far as we know, the second case reported in the literature. Carcinosarcoma was formed by an epithelial component represented by a high level transitional cell carcinoma and a mesenchymal component characterized by an unspecific fusocellular sarcoma with chondrosarcomatous differentiation. An immunohistochemical analysis was performed, confirming the dual nature of the carcinosarcoma.

Aged↗

PubMed1981

Histogenesis and culture of human uterine carcinosarcoma.

We set out to ascertain whether uterine carcinosarcoma represents: (a) a "collision tumor," i.e., a mixture of two histogenetically distinct malignant cell populations (endometrial carcinoma and sarcoma); (b) a "combination tumor" with both histological elements of common stem cell origin; or (c) a "composition tumor," i.e., an endometrial carcinoma with reactive, atypical stroma. In in vitro cultures of human uterine carcinosarcoma, we could separate two distinct, different cell types and succeeded in establishing adenocarcinoma cell lines (HWUA-1 and HWUA-2) and sarcoma cell lines (HWUS-1, HWUS-1a, and HWUS-2). These cell lines grew well for over 10 months. HWUS-1a was hypertetraploid, HWUA-1 and HWUA-2 were pseudodiploid, and HWUS-1 and HWUS-2 were hyperdiploid. These cell lines were transplanted into the subcutis of BALB/c nude mice and produced tumors. HWUA-1 and HWUA-2 cell produced poorly differentiated adenocarcinoma, HWUS-1 and HWUS-2 produced poorly differentiated sarcoma, and HWUS-1a produced well-differentiated leiomyosarcoma. These results support the combination tumor theory and reject the composition tumor theory as the cause of carcinosarcoma.

Adenocarcinoma↗

PubMedDate not supplied

Carcinosarcoma of the esophagus.

Two rare cases of carcinosarcoma of the esophagus are presented. In the first case the decision to operate was based on an initial diagnosis of leiomyosarcoma made by endoscopic biopsy. In the second, a diagnosis of carcinosarcoma was also obtained by endoscopic biopsy. The pathology is commented on. The authors discuss their opinion that carcinosarcoma of the esophagus constitutes a well defined anatomopathological entity.

Carcinosarcoma↗