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Carcinosarcoma of the lung with spindle-cell epithelial component: report of a case.

A case of primary endobronchial carcinosarcoma with predominant spindle cell squamous carcinoma is described. The spindle cell component has not been previously reported as occurring in pulmonary carcinosarcomas. We suggest that this variety of carcinosarcoma closely resembles sarcoma of the lung histologically and emphasize that a distinction between the two neoplasms is important in view of the generally good prognosis of endobronchial carcinosarcomas.

Carcinosarcoma↗

[Cystosarcoma phyllodes and sarcoma of the breast].

Altogether 217 phyllode tumours, 28 sarcomas and 5 carcinosarcomas of the mammary gland have been studied in the Institute from 1946 to 1980. Three structural variants of phyllode tumour are distinguished: 1) early stages of formation, 2) classical phyllode tumour, 3) phyllode tumour with sarcomatous stroma. 20 out of 28 sarcomas are linked with phyllode tumours while the morphogenesis of primary sarcomas, which are characterized by a more malignant clinical course, remains unclear. When studied electron-microscopically, classical phyllode tumour reveals marked and peculiar vascular proliferation which not infrequently coincides with cellular stroma. Various directions of functional and structural differentiation of stromal cells are observed. The alternation in the tumour of areas with different morphology found in light microscope is reflected by the dependence of the structure of intercellular substance upon the type of stromal cells observed electron-microscopically.

Breast Neoplasms↗

Primary and secondary pulmonary artery neoplasia mimicking acute pulmonary embolism.

Two cases of rare pulmonary neoplastic lesions (primary pulmonary artery sarcoma and pulmonary carcinosarcoma) directly involving the pulmonary artery and presenting with findings mimicking acute pulmonary embolism are discussed. Although this represents an unusual presentation for these two lesions, they should be included in the differential diagnosis of acute pulmonary embolism in patients presenting with somewhat atypical clinical, isotopic, and radiological features. Serial lung scans followed by angiography will prove useful in arriving at the correct diagnosis.

Adult↗

Association between erythrocytosis and renal cancers in rats following intrarenal injection of nickel compounds.

Seventeen nickel compounds were administered to Fischer-344 rats (N = 270) by intrarenal injection (7 mg Ni/rat); the compounds included nickel sulfides, selenides, arsenides, oxide, antimonide, telluride, titanate, ferronickel alloy and metallic nickel dust. Erythrocytosis, as defined by peak hematocrit values that averaged greater than 55% during 1-4 months post-injection, occurred in nine of 17 Ni-treated groups (NiS2, beta NiS, alpha Ni3S2, Ni4FeS4, NiSe, Ni3Se2, NiAsS, NiO, Ni dust). Renal cancers (N = 23) developed within 2 years post-injection in nine of 17 Ni-treated groups (NiS2, beta NiS, alpha Ni3S2, Ni4FeS4, NiSe, Ni3Se2, NiAsS, NiAs, NiFe alloy). The renal cancers included eight fibrosarcomas, five mesangial cell sarcomas, two renal cell carcinomas, two carcinosarcomas, two leiomyosarcomas, two undifferentiated sarcomas, one rhabdomyosarcoma and one nephroblastoma. No erythrocytosis or renal cancers occurred in control rats (N = 97) in three groups treated with the vehicles or metallic iron dust. Rank correlation (p less than 0.0001) was observed between the incidences of erythrocytosis and renal cancers in the 17 Ni-treated groups. Rank correlation (p less than 0.001) was observed between the present incidences of renal cancers and the sarcoma incidences previously reported following intramuscular administration of the 17 nickel compounds to Fischer-344 rats (14 mg Ni/rat). The incidences of renal cancer were not correlated with the mass-fractions of nickel in the 17 compounds, the dissolution half-times of the compounds in rat serum or renal cytosol, or the phagocytic indices of the compounds in rat peritoneal macrophages.

Animals↗

Immunohistochemical evaluation of the c-kit proto-oncogene in sarcomas of the uterus: a case series.

OBJECTIVE: To evaluate the incidence of c-kit expression in uterine sarcomas. STUDY DESIGN: Immunohistochemical evaluation for expression of c-kit was performed on specimens from 11 patients with pathologically documented uterine sarcomas. Histologic subtypes included 5 carcinosarcomas, 3 leiomyosarcomas and 3 endometrial stromal sarcomas. Histologic sections of formalin-fixed, paraffin-embedded hysterectomy specimens from patients with uterine sarcomas were immunostained with c-kit (CD117) antibody. Overall staining intensity was graded as strong, intermediate or weak. RESULTS: In all 11 patients with uterine sarcoma, c-kit immunostaining was positive. Four specimens demonstrated stronger staining intensity than did the gastrointestinal stromal tumor control. Five specimens demonstrated intermediate staining intensity. Two specimens demonstrated weak staining intensity. Furthermore, in the carcinosarcoma specimens both the epithelial and sarcomatous elements were positive for c-kit staining. CONCLUSION: In this case series, c-kit expression was demonstrated in all sarcomas of the uterus regardless of histologic type. These results suggest that such drugs as imatinib mesylate, which inhibit the c-kit tyrosine kinase, should be investigated for these mesenchymal neoplasms.

Biomarkers, Tumor↗

UVA irradiation increases the incidence of epithelial tumors in UVB-irradiated hairless mice.

The interaction of UVA and UVB radiation in tumorigenesis in lightly pigmented hairless hr/hr mice was studied. Seventy-eight tumors (5 sarcomas, 4 squamocellular carcinomas, 1 carcinosarcoma, 63 papillomas, 2 keratoacanthomas, 1 fibrous polyp and 2 adnexal tumors) occurred in 12 mice receiving high UVA (582 J/cm2) plus high UVB(EE) (erythemally effective) (1.0 J/cm2) doses, whereas only 28 tumors (6 sarcomas, 1 carcinosarcoma, 20 papillomas and 1 keratoacanthoma) were found in 12 mice receiving low UVA (71 J/cm2) plus high UVB(EE) (0.8 J/cm2) doses. In 12 mice receiving low doses of both UVA and UVB(EE), only 2 tumors (sarcomas) occurred. The predominantly epidermal tumor response in the high UVA-high UVB group suggests that UVA irradiation increases the number of epithelial tumors when given together with carcinogenic doses of UVB radiation.

Animals↗

[Bladder sarcomatoid carcinoma: report of a case].

A case of sarcomatoid carcinoma of the bladder is described. Its interest basically stems from the fact that this extremely aggressive tumor is uncommon in the bladder and there is existing controversy as to its anatomopathological distinction from other carcinosarcomas, spindle cell sarcoma and pseudosarcomatous bladder lesions.

Carcinosarcoma↗

[Synthesis and antitumor action of N,N-di(2-chlorethyl)-hydrazines of alpha-aminocarboxylic acid antimetabolites].

The N,N-di(2-chlorethyl)hydrazides of the following alpha-aminocarboxylic acid antimetabolites: methioninsulphoxide, ethionine, 2-, 3- and 4-fluorophenylalanine, 4-nitrophenylalanine and 2,2-dimethyl-thiazolidine-4-carboxylic acid were synthesized. Preliminary studies of the activity on experimental tumour models were carried out. It was shown that these compounds have a high antitumour effect (80-100%) on sarcoma Yoshida and carcinosarcoma Walker.

Amino Acids↗

Hysteroscopic endomyometrial resection of three uterine sarcomas.

STUDY OBJECTIVE: To describe our experience with three uterine sarcomas associated with hysteroscopic endometrial ablation. DESIGN: Cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated teaching hospitals. PATIENTS: Three of 2402 women undergoing hysteroscopic endometrial ablation who had uterine sarcomas. INTERVENTION: Hysteroscopic endomyometrial resection. MEASUREMENTS AND MAIN RESULTS: One low-grade endometrial stromal sarcoma and two carcinosarcomas were resected. After hysterectomy in two patients, no residual cancer was identified in one of them. The third patient was an 82-year-old woman with moderate menorrhagia who refused hysterectomy. After endomyometrial resection she remained amenorrheic for the last 14 months of her life. CONCLUSION: From our experience the incidence of uterine sarcomas is approximately 1/800 women undergoing hysteroscopic ablation for abnormal uterine bleeding. Complete endomyometrial resection is feasible and may be offered as diagnostic and palliative therapy in women at high risk for hysterectomy.

Aged↗

[Sarcomatoid carcinoma in breast].

OBJECTIVE: To observe the distinctive pathomorphological features of sarcomatoid carcinoma (SC) in mammary gland as well as its diagnosis and differential diagnosis. METHODS: 1 538 malignant tumors of the breast were reviewed. 15 cases (0.98%) were diagnosed as SC. AE1/AE3, carcinoembryonic antigen (EMA), vimentin, S-100 protein, actin, estrogen receptor (ER) and progesterone (PR) were performed with SP immunohistochemical staining methods. RESULTS: The SC were divided into four morphological types according to the distinctive features of their sarcomatoid components. (1) Polymorphic sarcoma type: sarcomatoid components are polymorphic; (2) Spindle cell type: sarcomatoid components consisted of spindle cells; (3) Osteoclastic giant cell type: a huge number of osteoclastic giant cells in the sarcomatoid components; (4) Myxocartilage type: myxocartilaginoid components are seen in the tumor tissue. With immunohistochemical staining, the expression rates of AE1/AE3, EMA, vimentin, S-100 protein and actins in the epithelial components were in 11, 15, 11, 12 and 8 cases respectively, and sarcomatoid components were in 10, 13, 13, 13 and 10 cases respectively, while ER and PR were positive only in 2 cases. CONCLUSION: Sarcomatoid carcinoma of the breast should be distinguished from carcinosarcoma, desmoplastic carcinoma, sarcoma, nodular fasciitis and fibromatosis.

Actins↗

Malignant pituitary tumors.

Pituitary malignancies are rare. The definition of pituitary malignancy is still subject to debate. Three types of malignancy with the description of clinical course and complete autopsy were presented; i) true carcinosarcoma, ii) ectopic sphenoid invasive tumor, and iii) post-irradiation sarcoma. The first true carcinosarcoma had a long natural tumor history of 46 years, ending in malignant transformation with extracranial metastasis from a pituitary adenoma. The second ectopic sphenoid tumor was prolactin-producing, locally invasive, with the intact pituitary gland. The third post-irradiation sarcoma was followed by chromophobe pituitary adenoma. The interval between irradiation to the adenoma and malignant transformation to fibrosarcoma was about 14 years.

Adenoma↗

Carcinosarcoma of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcoma components.

We report a case of true malignant mixed tumour (carcinosarcoma) of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcomatous components in a 68-year-old woman. The pleomorphic sarcomatous component behaved aggressively with lymph node and distant metastases. The biological behaviour of the individual components in a malignant mixed tumour makes it difficult to diagnose. We could find no previous report of epithelial-myoepithelial carcinoma as a component of a carcinosarcoma of the parotid.

Aged↗

Capacity for epithelial differentiation in synovial sarcoma: analysis of a new human cell line.

AIM: To analyse the capacity for epithelial differentiation in synovial sarcoma using a new human cell line. METHODS: A new human cell line, KU-SS-1, was established from a monophasic, spindle cell type of synovial sarcoma by grafting those cells on to severe combined immunodeficient (SCID) mice and then transferring them to in vitro culture systems. The KU-SS-1 cells were characterised by light and electron microscopy, and by immunohistochemical, flow cytometric, and cytogenetic analysis. RESULTS: Primary tumour and cultured cells at passage 20 showed a positive reaction for vimentin, which is a mesenchymal marker. After 40 passages, subcultured cells were injected into SCID mice to induce further tumours. These advanced subcultured cells and the tumour cells that they induced were positive for cytokeratin, an epithelial marker, and exhibited epithelial ultrastructural features such as intermediate junctions. Furthermore, two colour immunofluorescent analysis for proliferating nuclear cell antigen (PCNA) and intermediate filaments showed that a large number of PCNA expressing cells were positive for vimentin, and that part of this fraction also expressed cytokeratin. The existence of cells with reactivity for these three markers indicated that, in this cell line, a fraction with high proliferating capacity had both mesenchymal and epithelial markers. In addition, cytogenetically, this cell line expressed the SYT-SSX chimaeric transcript as a result of the t(X;18) (p11;q11) translocation. CONCLUSIONS: A human synovial sarcoma cell line was established and stably maintained in cell culture for more than 70 passages. In addition, this cell line showed epithelial differentiation, which supports the hypothesis that synovial sarcoma is a carcinosarcoma like tumour with true epithelial differentiation. This cell line will be a useful tool for investigating the nature of this tumour and will contribute to clinical studies.

Adult↗

Bioassay of blood-born tumour cells on in vivo and in vitro systems.

Viability and biological integrity of tumour cells circulating in the blood were studied in an experimental system using bioassay methods. Results of subcutaneous and intravenous retransplantation as well as explantation of the blood obtained from tumour-bearing animals previously receiving intravenous inoculation of tumour cell suspension (Yoshida sarcoma, Walker 256 carcinosarcoma and DMBA-induced myeloid ascitic leukaemia), revealed that the tumour cells detected in the blood are not only viable at the time of their transportation in the blood-stream but are also in possession of biologic potentials to proliferate and establish metastatic growths in organs.

Animals↗

Clinical outcomes of uterine sarcomas: results from 14 years worth of experience in the Kinki district in Japan (1990-2003).

To review clinical outcomes and therapeutic varieties, we were invited to submit data from the patients who were treated for uterine sarcomas in Japan from 1990 to 2003. Uterine sarcomas were defined as leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), and carcinosarcoma (CS). Of a total of 97 patients, 36 (37.1%) were diagnosed with LMS of the uterine corpus, 15 (15.5%) with ESS, 46 (47.4%) with CS. Median age at diagnosis was 59 (21-85) years. Clinical stages based on FIGO were 41 (42.3%) with stage I disease, 6 (6.2%) with staged II, 34 (35.1%) with stage III, and 16 (16.5%) with stage IV. The median follow-up period for all patients was 13 (1-108) months and median disease-free period was 9 (0-96) months. The 1-year survival rate and disease-free survival (DFS) rate were calculated in patients with all sarcomas (overall survival [OAS], 61.3%; DFS, 46.6%). Statistical analysis showed that younger age (less than 50 years), early stage (stages I and II), and surgical procedure (extended hysterectomy [EH] and radical hysterectomy [RH]) were associated with significantly better OAS. Histologic types did not affect the survival period. In conclusion, aggressive surgery including EH or RH at the time of initial operation offers the possibility of prolonged survival.

Adult↗