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The case of an eighty-two-year-old man with carcinosarcoma of the urinary bladder is presented. Morphologically, coexistence of two elements, transitional cell carcinoma and proliferation of spindle-shaped cells, is demonstrated, between which the transition is observed. The literature is reviewed, and the histogenesis of the sarcomatous element is discussed.
A case of carcinosarcoma of the prostate is described. Review of the literature revealed few cases, only 2 being well documented. The tumor presented as a urethral polypoid obstruction of the bladder neck and proved to involve bilaterally, the prostate and the seminal vesicles with metastases to the regional lymph nodes. Light microscopic findings are described as a multimorphic tumor with simultaneous presence of sarcoma, characteristically being malignant cartilage, rhabdomyosarcomatous component, and poorly differentiated carcinomatous areas. Controversy of this morphologic entity is discussed briefly. These tumors are highly anaplastic and rapidly fatal.
A case of carcinosarcoma of the bladder is presented. The most prominent element in an unusually heterogeneous neoplasm was the chondrosarcomatous element. Despite prompt preoperative radiotherapy and surgical extirpation, local recurrence resulted in death. In this case radiotherapy did not help and delayed surgical removal, thus perhaps adversely affecting the outcome.
A new case of carcinosarcoma of the renal pelvis is reported and the literature reviewed. This tumor occurs in patients over sixty years of age. Three patients died of the disease in one year, and 2 showed six-month and two-year disease-free survival after nephrectomy.
We report a case of true carcinosarcoma involving the urinary bladder, ureter, and renal pelvis in an eighty-year-old man. The patient underwent transurethral resection of the bladder tumor and left nephrectomy, followed by combination chemo- and radiotherapy. He died eighteen months after the nephrectomy.
Four cases of carcinosarcoma and mixed müllerian tumors of the fallopian tube are presented. Each patient presented with abnormal bleeding and a pelvic mass. All underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, staging, and cytoreduction. Disease was limited to the pelvis in two patients, analogous to FIGO stage IIB ovarian carcinoma; the other two patients had upper abdominal disease, analogous to FIGO stage III. The primary tumors were intraluminal and papillary. There were equal amounts of carcinoma and sarcoma in three tumors; in one, sarcoma constituted only a small intraluminal focus. The sarcoma was predominantly homologous, with foci of heterologous elements present in three tumors. Adjuvant therapy consisted of pelvic radiation in two patients. One patient died of inanition within one year of diagnosis. The other patient, who had the small focus of sarcoma within a stage IIB carcinoma, had an 11-year disease-free interval before retroperitoneal recurrence of carcinoma. Two patients received chemotherapy. A stage IIB patient, after pelvic radiation, received Cytoxan and Adriamycin; she is clinically free of disease after 6 years. A stage III patient lived over 3 years after treatment with multiple agents; she responded to Cytoxan and cis-platinum before suffering a systemic relapse and death.
A patient with Stage III fallopian tube carcinosarcoma treated with cisplatin, doxorubicin, and cyclophosphamide, surviving 31 months disease-free after diagnosis, is presented. Review of the literature revealed this is the 28th case report of malignant mixed Mullerian tumor of the fallopian tube, and fifth instance in which chemotherapy was used as a primary therapy. Modern chemotherapy appears to have improved survival.
A cell-line (UACC 2561), was established from a biopsy specimen of a lung carcinosarcoma. The patient had Stage III non-small cell lung cancer. Characterization of this cell line revealed highly aneuploid cells containing multiple clonal chromosome alterations with growth in nude mice within 3 weeks following subcutaneous injection. The cell line UACC 2561 stained positive for vimentin and displayed resistance to a variety of chemotherapeutic agents. Polymerase chain reaction followed by single-strand conformational polymorphism analysis revealed the presence of a K-ras 12 codon mutation. This mutation was confirmed by mutation specific PCR analysis for mutant K-ras alleles and direct DNA sequencing to be a GGT to GTT at codon 12 of the K-ras gene. Examination by PCR-SSCP for p53 mutations did not reveal any point mutations in exon 5-8 of the p53 gene. This relatively rare cell line may represent a useful model to investigate human lung sarcomas.
We evaluated the usefulness of TNP-470 as an anti-cancer agent on a human uterine carcinosarcoma cell line (FU-MMT-1). FU-MMT-1 induced human arterial endothelial cell (HAEC) tube formation on an in vitro co-cultured model of FU-MMT-1 and HAECs on a matrix gel, and was blocked by vascular endothelial growth factor (VEGF)-2 receptor (KDR/Flk-1) tyrosine kinase inhibitor. Lower concentration of TNP-470 inhibited the tube formation. Cell proliferation of FU-MMT-1 but not HAEC was inhibited by lower concentration of TNP-470. In addition, lower concentration of TNP-470 blocked VEGF production on FU-MMT-1. Our results suggest that TNP-470 directly inhibited FU-MMT-1 but not HAEC growth accompanied with the inhibition of VEGF production, subsequently induced anti-angiogenesis on HAEC.
Paraneoplastic syndromes are a collection of disorders affecting an organ or tissue caused by cancer but occurring at a site distant from the primary or metastases. Dermatomyositis can occur in association with malignancy as a paraneoplastic phenomenon. We present a case of a patient presenting simultaneously with an advanced carcinosarcoma of the uterus and dermatomyositis. The diagnoses, pathophysiology and treatment of these two conditions are discussed and current published studies reviewed.
This report describes a case of a carcinosarcoma or true malignant mixed tumour (salivary gland type) of the trachea in a Belgian Blue heifer. At post-mortem examination a nodular, well-circumscribed, firmly attached mass was found in the tracheal wall, severely compressing the tracheal lumen. Histologically the tumour was biphasic, with varying proportions of epithelial elements dispersed throughout a matrix showing varying degrees of myxo-chondroid and cartilaginous differentiation. The histological features of the tumour were consistent with a combination of an adenoid cystic carcinoma and a chondrosarcoma. Immunolabelling demonstrated smooth muscle actin in the cytoplasm of both the epithelial and mesenchymal components, thus fulfilling the diagnostic criteria for a mixed tumour. To our knowledge this is the first report of a mixed tumour of the trachea in a domestic animal.
A biphasic odontogenic tumor with aggressive clinical behaviour is reported. The tumor arose posterior to the right mandibular third molar involving the angle of the mandible and the ascending ramus. Within a 5 years period the patient suffered from two episodes of local progression and final disease generalization occurred 6 years after initial surgical therapy. On histopathologic evaluation, both recurrences and the distant metastasis preserved the biphasic pattern seen in the primary tumor with both epithelial and mesenchymal components exhibiting clear cytological features of malignancy. There was no evidence of sarcomatous overgrowth within the progression of the tumor. By contrast, the proportion of the epithelial component was even enlarged in the second recurrence. Thus, both pathologic features and clinical behaviour clearly distinguishes this tumor from ameloblastic fibrosarcoma and demonstrates the clear morphological as well as clinical characteristics of a true malignant mixed type tumor with a definite sarcomatous and carcinomatous component. Thus, even though a very rare lesion, our case supports the consideration of the odontogenic carcinosarcoma as an individual entity.
BACKGROUND: The objective of this study was to compare the clinical presentation and outcomes of women with ovarian and uterine carcinosarcoma (CS). METHODS: We performed a retrospective review of patients treated for uterine or ovarian CS from 1952 to 2003. Fisher's Exact Test was used to compare patient characteristics. Survival curves were estimated using the Kaplan-Meier method and compared using the log rank test. RESULTS: We identified 87 patients with uterine CS and 18 with ovarian CS. There was no difference in age, body mass index, parity, menopausal status, family history of cancer, history of pelvic radiation, diabetes or hypertension between the two groups. 43% of women with uterine CS presented at stage I/II, compared to 28% of women with ovarian tumors (P = 0.0003). 82% of patients with ovarian tumors received adjuvant chemotherapy with or without radiation; 51% of the patients in the uterine CS group received adjuvant radiation therapy. The median length of follow-up was 13 months. There was no difference in the Kaplan-Meier estimates of overall survival between the two disease sites. The median survival for uterine CS patients was 16 months, compared to 11 months in the ovarian CS group; HR = 0.991 (95% CI = 0.534, 1.839). CONCLUSIONS: We found no differences in patient demographics between the two groups. Despite differences in stage and initial treatment, there was no difference in survival between women with uterine and ovarian CS.
An unusual tumor of the ureter in an elderly man is reported. The tumor showed evidence of epithelial and mesenchymal differentiation based on histological and immunocytochemical criteria, and it behaved aggressively, comparable to that seen in other mixed tumors of this type arising from elsewhere within the genitourinary tract. It is proposed that this tumor be designated carcinosarcoma of the ureter.
Sarcomas of the bladder occur rarely in adults. As a result, the natural history of these unusual tumors and the best methods of treatment are uncertain. We reviewed our experience with 13 patients presenting between 1970 and 1980 (5 had leiomyosarcoma, 5 had carcinosarcoma and 3 had rhabdomyosarcoma). Gross hematuria nearly always was the presenting symptom. Patients treated by partial cystectomy fared poorly, while 7 treated by radical cystectomy and supravesical urinary diversion had an excellent prognosis: 6 (86 per cent) have been free of disease for more than 1 year, including 4 who have survived more than 45 months without evidence of recurrence or metastasis.
We report the third case of carcinosarcoma of the prostate. The epithelial element consisted of a highly malignant adenocarcinoma. The mesenchymal component was composed of malignant osteosarcoma and chondrosarcoma.
We present 2 cases of carcinosarcoma of the bladder. These tumors are considered as true admixtures of epithelial and mesenchymal neoplastic cells rather than 2 separate neoplasms that touch or marginally invade each other. Although the etiology of this tumor is unclear it tends to be aggressive and probably requires an early radical operation with adjuvant radiotherapy and chemotherapy.
An unusual heterologous carcinosarcoma of the renal pelvis is reported. The differential diagnosis, problems related to nomenclature and histogenetic implications of this rare neoplasm are discussed.