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A 66-year-old woman was admitted to hospital because of a persistent cough and hemoptysis. Her chest X-ray showed a coin lesion in the S10 area of her right lung. The tumor was resected and its histologic features showed it to be a so-called carcinosarcoma of the lung.
A thyroid carcinosarcoma--a rare neoplasm of the thyroid gland--in an elderly woman is described. On histological examination the tumour showed the characteristic biphasic pattern of follicular carcinoma and mesenchymal differentiation with a chondrosarcomatous component and osseous metaplasia. The clinical features and details of the histopathological and immunohistological examinations of this tumour are reported.
The authors describe the clinical and pathologic features of uterine carcinosarcoma. In the case of a 45 year old patient the rarity of this double tumor is pointed out.
Carcinosarcoma of the breast is a rare neoplasm which has been reported less than 20 times. Comprised of both malignant epithelial and malignant connective tissue components, it may radiographically exhibit features of either cellular element. We report the first film-screen mammographic description of such a lesion in a breast. Osteoid matrix calcification demonstrated mammographically should, in retrospect, have suggested osteogenic elements preoperatively.
The case of a 60-year-old woman with a five-year history of abdominal pain, jaundice, and weight loss is presented. On physical examination a hard mass on her right flank was evident. She died under unknown circumstances while she was waiting to be examined. At post-mortem examination the gallbladder was replaced by a neoplasm and there were gallstones within its lumen. Histologically, the tumour was constituted by a mixture of adenocarcinoma, squamous cell carcinoma and undifferentiated sarcoma. The diagnosis of carcinosarcoma of the gallbladder was established. A review of previously reported cases is presented too.
A 56-year-old man with carcinosarcoma of the bladder diverticulum is reported. Histologically, the tumor contained two elements: carcinomatous and sarcomatous components with a transitional phase between them. The related literature is also reviewed.
Carcinosarcomas of the skin are extremely rare. Two such cases have been recorded in the literature. In the two cases reported, the epithelial component consisted of a well differentiated squamous cell carcinoma and the mesenchyma of a malignant fibrous histiocytoma. Immunohistochemistry was applied for the confirmation of the diagnosis.
A thyroid carcinosarcoma composed of follicular carcinoma intermixed with osteosarcoma and chondrosarcoma was studied. Results of immunoperoxidase staining for thyroglobulin were positive in the areas of follicular carcinoma and negative in the sarcomatous component. Likewise, the carcinomatous areas showed thyroid epithelial characteristics by ultrastructure, while the sarcomatous areas showed typical mesenchymal differentiation. This is an extremely rare neoplasm, with only 16 cases reported in the literature. It occurs predominantly in elderly women, is thought to arise through a process of neoplastic metaplasia, and has a uniformly dismal prognosis. Immunoperoxidase and ultrastructural studies, the first reported in such lesions, proved helpful in ascertaining the sarcomatous nature of the anaplastic, mesenchymal component of this unusual and aggressive neoplasm.
A patient who was 61 years of age had obstruction of the thoracic duct by metastases from an adenocarcinoma of the endometrium together with a carcinosarcoma of the tube. She developed chylous ascite. The diagnostic approach and the treatment has been reviewed by the authors.
Cytologic examination of sputum samples from an elderly patient revealed the presence of two cell populations: squamous cell carcinoma cells and rhabdomyosarcoma cells. The abnormal squamous cells showed both keratinizing and nonkeratinizing forms while some of the rhabdomyosarcoma cells showed cross striations. Sputum cytology was thus able to suggest a diagnosis of pulmonary carcinosarcoma. Histologically, the tumor was composed mainly of sarcomatous tissue showing various kinds of cells: fusiform or fibrous cells, round anaplastic cells, spindled cells with typical cross striations and myoblastic cells. A partially myxomatous degeneration was present. In addition, squamous cell carcinoma proliferated along the bronchi and formed small invasive cell nests in the sarcomatous tissue. No transition between the two components was noted. Both cellular constituents had metastasized to an interlobar lymph node.
We report two cases of a carcinosarcoma and a pseudosarcoma of the esophagus and discuss the clinical, radiologic and histopathologic findings.
A 56-year-old woman presented with a carcinosarcoma consisting of a small focus of adenocarcinoma and a larger endometrial stromal sarcoma component. Although a preoperative endometrial biopsy revealed only adenocarcinoma, an endometrial smear obtained with an endometrial brush sampler revealed many undifferentiated malignant cells and a smaller number of adenocarcinoma cells. These undifferentiated malignant cells were cytologically identical to the stromal sarcoma cells in an imprint smear from the surgically removed tumor. The cellular and ultrastructural features of the stromal sarcoma are described in detail.
Carcinosarcoma of the stomach is an uncommon lesion of uncertain histogenesis. Light microscopic, immunohistochemical, and electron microscopic examinations of the tumor in the present case favor the view that these carcinosarcomatous tumors may arise from mesenchymal (or sarcomatous) transformation of carcinoma cells.
CT was preoperatively performed in a patient with gall-bladder carcinosarcoma. This very rare mixed tumour consists of epithelial and mesenchymal elements that can also contain cartilage and bone tissue. This appeared in the computer tomogram as an atypical calcification. Infiltration of the right lobe of the liver was also seen.
A carcinosarcoma of the prostate was examined by light and electron microscopy. The epithelial component was comprised of adenosquamous carcinoma. The stromal component demonstrated osseous and cartilaginous differentiation, and appeared mesenchymal by fine structure analysis. Despite aggressive therapy the patient died with disseminated disease 5 months after diagnosis.
A case of carcinosarcoma of the esophagus and a review of literature are presented. The pertinent clinical and pathological data are summarized. There have been 51 reported cases of which 31 underwent surgical resection of the lesion; there have been three five-year survivors. Although the cumulative experience with this malignancy is limited, it is apparent that the presentation and clinical course of this tumor is not substantially different from the more common squamous cell carcinoma. Therefore, the diagnostic and therapeutic management should not vary from that of any malignant esophageal lesion.
Carcinosarcomas are malignant tumors containing both epidermal and mesodermal components. They are rare in the esophagus, but when present frequently have a characteristic radiographic appearance presenting as a bulky, intraluminal, polypoid filling defect. Although capable of metastatic spread, their usual indolent nature offers a relatively favorable prognosis.
The paper deals with the results of application of clinical, cytologic and complex clinico-cytologic procedures of diagnosis of fibroadenoma phylloides mammae (160), sarcoma developing from libroadenoma phylloides (17), carcinosarcoma (5) and stromal or primary sarcoma (7). All the cases were treated at the Institute in 1960-1980. The difficulties involved in clinical diagnosis of these tumors are discussed. Correct clinical diagnosis was made only in 17% whereas benign and malignant tumors were identified in 94.7%. Cytological examination serves to improve the differential diagnosis between such neoplasms. Due to its application, the histological pattern of tumor was established in 30.6% and the benign or malignant nature of tumor--in 81.5%. When a complex clinico-cytologic examination was conducted diagnosis was improved in nearly half the cases (44.9%).