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PubMed1976

Carcinosarcoma of the bladder: case report and review of the literature.

A 36-year-old man with carcinosarcoma of the bladder is described. The literature is reviewed and the clinicopathology is discussed. These tumors tend to be bulky, rapidly growing, invasive and recur locally. Metastases are generally hematogenous and may rarely involve regional nodes. Deaths are commonly owing to local invasion and sepsis. Preoperative overstaging may occur and pelvic arteriography and exploration are recommended in questionable cases. Because of the difficulty in locally extirpating these tumors radical cystectomy and urinary diversion are recommended.

Adult↗
PubMed1981

Histochemical and ultrastructural features of an unusual pulmonary carcinosarcoma.

An autopsy case is presented in which a pulmonary carcinosarcoma filled the left chest of a 61 year old man. The extensive pleural involvement that this neoplasm exhibited has not been reported previously. By light microscopy the neoplasm initially was considered a mesothelioma because of the pattern of glands and undifferentiated sarcomatous stroma. However, by electron microscopy the sarcomatous component was found to show rhabdomyoblastic differentiation. Neither histochemical stains nor electron microscopy supported a mesothelial origin for the glandular component. Differential diagnostic considerations of pleuropulmonary neoplasms showing rhabdomyosarcomatous differentiation are discussed. This case illustrates the importance of detailed study in order to characterize and properly classify these neoplasms.

Carcinosarcoma↗
PubMed1984

Carcinosarcoma of ileum in regional enteritis.

A biphasic malignant neoplasm, carcinosarcoma, arose in a segment of ileum involved with regional enteritis. The tumor spread throughout the abdomen, and the patient died nine months after diagnosis. The spectrum of intraepithelial dysplasia, carcinoma with varying degrees of differentiation, and sarcomatous-appearing elements suggests that the histogenesis of this tumor is epithelial. This report provides further documentation of the relationship between regional enteritis and unusual neoplasms of the intestine.

Carcinosarcoma↗
PubMed1998

Carcinosarcoma of the breast: molecular-biological study for analysis of histogenesis.

The histogenesis of carcinosarcoma of the breast is controversial. In the current case, the demarcation between the carcinomatous and sarcomatous components was distinct in all microscopic fields. Immunohistochemical analysis was negative for epithelial membrane antigen (EMA) and keratin in the sarcomatous component and was negative for desmin in the carcinomatous component, suggesting that this tumor could be derived from the two different stem cells. To determine the histogenesis of this tumor, both carcinomatous and sarcomatous lesions were microdissected from formalin-fixed tissues and DNAs were prepared by proteinase K digestion. PCR amplification of the human androgen receptor (HUMARA) short tandem repeat (STR), after Hpa II digestion of the genomic DNA, indicated that the patterns of X-chromosome inactivation were identical in both components. Moreover, both components contained the identical TGT --> TTT transversion in codon 275 of the p53 gene. These observations strongly support the hypothesis that this tumor is derived from a single totipotent stem cell.

Breast Neoplasms↗
PubMedDate not supplied

Carcinosarcoma of the salivary gland.

A 59-year-old woman had carcinosarcoma of the salivary gland. Salivary gland tumors of this type are aggressive and rare. Most patients die of the tumor, but surgical cure has been reported in one case.

Carcinosarcoma↗
PubMed2004

[Carcinosarcoma of the bladder: report of our cases and review of the literature].

Carcinosarcomas of the bladder are rare. As a result, the natural history of them and the best methods of treatment remain uncertain. These tumors tend to be rapidly growing, invasive and recur locally. We reviewed our experience with four patients presenting between 1995 and 2002. Epidemiology findings, clinical aspects, histological features, diagnostic methods, treatment and survival are discussed in relation to literature.

Aged↗
PubMed1989

True carcinosarcoma of the maxillary sinus.

A case of true carcinosarcoma primarily arising in the right maxillary sinus is reported in a 60-year-old male. His chief complaints were right nasal obstruction and bleeding. Histological findings of the biopsied primary tumor revealed two components of keratinizing squamous cell carcinoma and osteosarcoma which were intricately intermingled. Despite intensive irradiation and chemotherapy, and total maxillectomy, he finally died of rapid tumor recurrence and widely spreading metastases to lungs, pleurae and brain two months later. At autopsy the recurrent and metastatic tumors consisted entirely of the osteosarcoma component, suggesting the efficiency of the radiotherapy and chemotherapy against the carcinomatous component, but not against the sarcomatous one. As for histogenesis, this case was compatible with a combination tumor judging from histologic, immunohistochemical and electron microscopic findings.

Carcinosarcoma↗
PubMed1999

A case report of gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation.

We report herein an unusual gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation in a 63-year-old Japanese male. The tumor was a pedunculated large polypoid tumor (7 x 6.5 x 3.5 cm) located in the pylorus. Histologically, it invaded to the subserosa and was composed of both adenocarcinomatous and sarcomatous components. Adenocarcinomatous foci generally showed tubular to solid patterns and occupied the parts facing the gastric lumen, while the sarcomatous components showed a generally irregular and solid arrangement. There were transitions between the sarcomatous and carcinoma elements. In addition, carcinoma cells with a cord-like or trabecular arrangement similar to that seen in endocrine carcinoma expressed chromogranin A, and were mainly observed in an intermediate area between the adenocarcinomatous and sarcomatous foci. The sarcomatous areas were mainly composed of spindle cells and occasionally contained a sarcomatous component showing rhabdomyosarcomatous differentiation. This is an interesting case to consider how the variety of cell type appeared in such a type of tumor in the stomach.

Biomarkers, Tumor↗
PubMed2004

[Lung carcinosarcoma. A case report].

Carcinosarcoma of the lung is a rare highly malignant tumor of unknown histogenesis. There is an epithelial carcinomatous component and a malignant mesenchmatous component with heterologous tissue. Survival at two years after surgical resection is not greater than 10%. We report a case observed in a 71-year-old man who developed chest pain. Outcome was fatal at three months. Pathology examination of a transparietal biopsy provided the diagnosis which was confirmed by immunohistochemistry on the surgical resection specimen.

Aged↗
PubMed2003

Primary pulmonary sarcomas and carcinosarcomas--postoperative results and comparative survival analysis.

OBJECTIVE: To evaluate the early and long-term results after surgery for primary pulmonary sarcomas (PPS) and to compare them with those of patients with pulmonary carcinosarcomas (PCaSa). METHODS: During a 20-year period, 48 patients with PPS and 15 patients with PCaSa underwent surgery. There were 40 males and 23 females with a mean age of 52.1 years (range 13-78). The histologic diagnoses in PPS group were fibrosarcoma (15), fibroleiomyosarcoma (10), leiomyosarcoma (6), rhabdomyosarcoma (6), hemangiopericytoma (3), epitheloid hemangioendothelioma (3), malignant schwannoma (1), liposarcoma (1) and undifferentiated sarcoma (3). The following curative resections were carried out: lobectomy (36), including two sleeve lobectomies (in PPS group), pneumonectomy (15) and polysegmental resections (4). In four PPS cases, these procedures were extended to the thoracic wall, diaphragm or pericardium. An atypical resection was applied in one PPS patient (the tumor was falsely classified as benign on frozen section examination). Exploratory thoracotomy was performed in five of PPS patients (11%) and in two of those with PCaSa (13%). The majority of PPS patients were with low stages I and II (76%). The PCaSa patients were predominantly with stage IIIA (39%). RESULTS: No postoperative death was registered. Major complications included two localized empyemas (4.2%) in PPS and one reoperation for bronchial stump fistula (6.7%) in PCaSa groups. Local recurrences were operated on in one patient per group (2.1 and 6.7%, respectively). Follow-up was available on 57 patients and ranged from 4 to 148 months. The overall cumulative 5-year survival was 48.81% for PPS and 49.38% for PCaSa patients (P=0.9035). It was better in low vs. higher stage cases, statistically significant in PPS group (P=0.0005) and without significant difference in PCaSa cohort (P=0.11). CONCLUSIONS: Complete resection of PPS and PCaSa favors an acceptable survival, especially in low stages. There is no significant difference in the survival rates between PPS and PCaSa patients, despite the greater number of cases with higher stages in PCaSa group.

Adolescent↗
PubMed1992

True carcinosarcoma of the larynx.

A case of carcinosarcoma of the larynx and pyriform sinus with sarcomatous and epithelial malignant components is described in a 68-year-old male. The primary site was composed of spindle-shaped malignant mesenchymal cells with osteosarcomatous and chondrosarcomatous differentiation intermingled with areas of well differentiated squamous cell carcinoma, tubular and papillary adenocarcinoma, and trabecular neuroendocrine carcinoma. The metastatic lymph node showed squamous cell carcinoma and chondrosarcoma. Immunohistochemical studies showed that keratin was present in epithelia cells and negative in sarcoma, whereas vimentin and S-100 protein were present in sarcoma, but negative in carcinoma. Neuron-specific enolase was present in the neuroendocrine part of the tumour.

Aged↗
PubMed1995

Polypoidal carcinosarcoma of the oropharynx: a clinicopathological and immunohistochemical study.

Polypoidal squamous cell carcinomas, with a sarcomatous stroma, in the upper aerodigestive tract are very rare but well described tumours. They are associated with a multifarious nomenclature because of different opinions regarding their histology and histogenesis. The main issue is whether the stroma component is a true sarcoma or a benign reactive lesion. In order to draw the attention of otolaryngologists and pathologists to the characteristic features of this rare tumour, two cases originating from the oropharynx are presented. Both tumours were pedunculated and polypoidal, and their bulk consisted of a bizarre sarcoma-like stroma covered with granulation tissue. In some areas of the surface, however, atypical squamous cell epithelium with foci of invasive carcinoma was found. In the vicinity of the latter both tumours contained areas of adenocarcinoma. After surgical excision followed by radiation therapy, there was no recurrence after two and five years, respectively. The histological and immunohistochemical findings support the assumption that these two tumours are carcinosarcomas. Adenocarcinomatous elements in this type of tumour have to our knowledge been reported only twice previously and have never been observed in the pharynx.

Adenocarcinoma↗
PubMed2001

Teratoid carcinosarcoma of the ovary with prominent neuroectodermal differentiation.

We present what we believe to be only the second report of ovarian teratoid carcinosarcoma. The patient, a 59-year-old woman, was admitted to hospital complaining of a pelvic mass and of abdominal fullness. Advanced ovarian cancer was diagnosed, and a tumorectomy was done. The tumor occupied the pelvis, and metastasis was found in the liver and spleen. The solid tumor was composed of chondrosarcoma, squamous cell carcinoma, adenocarcinoma and malignant neuroectodermal components, which contained ganglioneuroblastoma-like and medulloepithelioma-like areas. Immunohistochemically, the neuroectodermal cells were positive for both neural and epithelial markers. This ovarian tumor consisted of frankly malignant components, with prominent neuroectodermal elements mixed with epithelial and mesenchymal elements in an organoid fashion; a quite rare tumor.

Biomarkers, Tumor↗
PubMed2002

Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations.

We report a case of carcinosarcoma of the esophagus characterized by ductal and myoepithelial differentiation. A 61-year-old man was operated on for a polypoid tumor of the distal esophagus. Histologically, this tumor was composed of ductal structures and sarcomatous spindle cells surrounding the ducts at the central area of the tumor. The tumor was also composed of squamous cell and basaloid carcinoma in the periphery. Immunohistochemically, a few spindle cells surrounding the ductal structures showed immunopositivity for alpha-smooth muscle actin and S-100 protein. Electron microscopy revealed that the spindle cells had tonofilament and pinocytic vesicles in the cytoplasm, and basal lamina adjacent to the cytoplasmic membrane. Both of the results strongly supported the suggestion that the spindle cells may be myoepithelial cells. Basaloid carcinoma showed a gradual transition to chondrosarcomatous cells producing the matrix, which had both immunopositivities for S-100 protein and cytokeratin. Therefore, chondrosarcomatous cells may be derived from carcinoma cells. The histogenesis of this tumor may be associated with a totipotent stem cell of esophageal mucosa, which has the potential to differentiate into squamous cells, ductal cells or myoepithelial cells.

Actins↗
PubMed2003

Hepatoid carcinoma of the uterus that collided with carcinosarcoma.

The case of a 68-year-old woman who was seen at Tokyo Kousei Nenkin Hospital because of abnormal genital bleeding is described. A malignant uterine tumor was suspected based on biopsy results. Hysterectomy and bilateral salpingo-oophorectomy were performed. Grossly, a solid whitish tumor occupied the area from the endocervix to the uterine body. On the consecutive fundal side, a whitish tumor protruded into the uterine cavity. Histologically, the tumor occupying the endocervical side showed a trabecular growth pattern. Many periodic acid-Schiff (PAS)-positive hyaline globules were observed. The cytoplasm of the tumor cells and the hyaline globules were immunohistochemically positive for alpha-fetoprotein (AFP). The tumor occupying the fundal side was identified as having endometrioid adenocarcinoma and spindle cell sarcoma components. The two tumors collided at a clear boundary. The present case was pathologically diagnosed as a collision cancer involving a hepatoid carcinoma and a carcinosarcoma. To our knowledge, this is the fourth reported case of a hepatoid carcinoma of the uterus. When no lesion is detected in the liver and stomach of a patient whose serum AFP level is abnormally high, the female reproductive system, such as the ovaries and uterus, should be examined as a possible site of AFP-producing cancer.

Aged↗
PubMed2003

Carcinosarcoma (pure endocrine cell carcinoma with sarcoma components) of the stomach.

A case of gastric carcinosarcoma with a rare histology is reported. Grossly, a huge ulcerative tumor (Borrmann type 3 tumor, measuring 10 x 6 cm) was observed on the lesser curvature side of the stomach. Microscopically, the tumor consisted of carcinoma and sarcoma components. The main tumor component consisted of an endocrine cell carcinoma exhibiting positive reactions for cytokeratins, chromogranin A, synaptophysin, and CD56. The sarcoma component occupied less than 10% of the entire tumor area and consisted of spindle cells, some of which showed a rhabdomyosarcoma differentiation. Some of the spindle cells also showed an atypical cartilage or osseous differentiation. This sarcoma component exhibited positive staining not only for vimentin and desmin, but also for cytokeratins. Transitions between these two components were occasionally observed. These findings suggest that the sarcoma component in our case most likely originates from the endocrine cell carcinoma component.

Carcinosarcoma↗
PubMed2001

Synchronous occurrence of bladder carcinosarcoma and testicular seminoma.

We report a case of urinary bladder carcinosarcoma with simultaneous testicular seminoma. A 60-year-old male presented with painless gross hematuria and a left testicular mass. The bladder tumor was deeply infiltrating muscular tissue and had histologic features of both carcinoma and sarcoma. Testicular tumor was diagnosed as classical seminoma. Radical cystectomy, pelvic and left-modified retroperitoneal lymphadenectomy were performed. The lymph nodes did not show metastasis. At the 26 months follow-up, the patient is free of disease.

Carcinosarcoma↗