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PubMed2001

Uterine carcinosarcoma with melanocytic differentiation.

A 65-year-old black woman was found to have a 3.0 cm endometrial tumor that was a carcinosarcoma with a major epithelial and a less prominent mesenchymal component. The latter was undifferentiated but one focus of chondroid differentiation was noted. The former showed papillary serous differentiation. Melanin pigment was observed in both epithelial and mesenchymal components. Staining with antisera to S100 protein and HMB-45 confirmed the presence of melanocytes. An endocervical focus of tumor also contained melanin. Electron-microscopic studies showed large tumor cells with an irregularly indented nucleus and abnormal giant cytoplasmic melanosomes. Only one case of uterine carcinosarcoma with melanocytic differentiation has been previously reported.

Aged↗
PubMed2005

Carcinosarcoma of the urinary bladder: a case report.

Carcinosarcomas are rare tumours containing both malignant mesenchymal and epithelial elements. This reports presents a 70-year-old man with carcinosarcoma of the urinary bladder, which is proven histologically.

Aged↗
PubMed2004

Primary sweat gland carcinosarcoma of the scrotal skin.

BACKGROUND: Carcinosarcoma is a biphasic tumor composed of malignant epithelial and mesenchymal elements. Although the tumors have been reported in different locations, they rarely occur in the skin and have not been reported in the skin of external genitalia. CASE REPORT: We present such a case in a 71-year-old Taiwanese man. He had had a long-term indolent nodule on scrotal skin, but it enlarged rapidly in 2 weeks. Wide excision of the tumor was performed. RESULTS AND DISCUSSION: The pathologic examination revealed a sweat gland carcinosarcoma consisting of admixed mucin-producing adenocarcinoma and solid spindle cell sarcoma. The two components exhibited contrasting immunohistochemical profiles with the epithelial component diffusely positive for epithelial markers and S-100 protein, while the sarcomatous component positive for vimentin and smooth muscle actin but negative for epithelial markers and S-100 protein. The immunoreactivity for S-100 protein in the epithelial component supports sweat gland origin. The tumor behaved aggressively. Local recurrence and distant metastases to lungs and brain occurred 6 months and 18 months later. The patient died of the disease 20 months after the initial diagnosis.

Aged↗
PubMed2003

Different expression patterns of KIT, EGFR, and HER-2 (c-erbB-2) oncoproteins between epithelial and mesenchymal components in uterine carcinosarcoma.

Uterine carcinosarcoma histologically comprises the components of epithelial and mesenchymal malignancies, and is known to be clinically highly aggressive. To reveal the significance of the expression of tyrosine-kinase-receptor-type oncoproteins in this tumor type, the incidence and distribution of the KIT, EGFR, and HER-2 (c-erbB-2) oncoproteins were immunohistochemically examined in 16 surgically resected cases. For 6 cases, the EGFR and HER-2 amplifications were also examined by fluorescence in situ hybridization (FISH). In the epithelial component, overexpressions of KIT, EGFR, and HER-2 were detected in 4 (25%), 5 (31%), and 9 (56%) cases, respectively, whereas these overexpressions in the mesenchymal component were detected in 6 (38%), 8 (50%), and 1 (6%) cases, respectively. KIT and EGFR were co-overexpressed in the mesenchymal component of 4 cases and in the epithelial component of 2 cases. However, HER-2 overexpression was mostly detected in the epithelial component only, and tended to occur independently of KIT and/or EGFR overexpression. By FISH, one of the 4 cases with HER-2 overexpression showed low-level gene amplification. In two cases with EGFR overexpression, the gain of EGFR alleles and/or polyploidization of chromosome 7 had occurred. The expression patterns of KIT, EGFR, and HER-2 differed between the epithelial and mesenchymal components, and the regulation of their expression appeared important in the acquisition of mesenchymal metaplasia in uterine carcinosarcoma. Structural and/or numerical alterations of chromosomes might be in part involved in EGFR and/or HER-2 overexpression in this tumor type.

Carcinosarcoma↗
PubMed1992

Thymic carcinosarcoma associated with a spindle cell thymoma: an immunohistochemical study.

A case of thymic carcinosarcoma associated with a spindle cell thymoma in a 71-year-old woman is reported. Histological and immunohistochemical studies of the carcinosarcoma showed two quite different components: the sarcomatous component included cells with myoid differentiation which stained for desmin and muscle specific actin, and some isolated cells which stained positively for low molecular weight cytokeratin, while the carcinomatous component, which formed less than 10% of the tumour, showed an epithelial phenotype, being positive for low and high molecular weight cytokeratin and epithelial membrane antigen. The thymoma cells showed epithelial markers, and a few cells were also positive for desmin and muscle specific actin. The rarity of this tumour and its possible histogenesis are discussed.

Aged↗
PubMed1993

Carcinosarcoma of the oesophagus with rhabdomyoblastic differentiation.

We report a case of oesophageal carcinosarcoma with prominent rhabdomyoblastic differentiation. Immunohistochemically, the rhabdomyblasts were mainly reactive to vimentin, cytokeratin, desmin, muscle-specific actin, myosin, and myoglobin, and were surrounded by laminin and type IV collagen-positive basement membranes. The tumour had dual differentiation, carcinomatous and sarcomatous, but also showed evident features of transition between the two components; suggesting a common origin. An epithelial-mesenchymal conversion could be the pathogenetic mechanism involved in the histogenesis of this lesion. The word carcinosarcoma, from a descriptive point of view, seems the most suitable to describe a tumour composed of both carcinomatous and true sarcomatous elements.

Aged↗
PubMed1979

Collision tumor of the stomach with carcinosarcoma and tubulo-papillary adenocarcinoma.

The present case is an autopsy case of a 66-year-old male who developed a collision tumor in the stomach which originated from carcinosarcoma of Borrmann type II in the gastric antrum and from papillary adenocarcinoma of Borrmann type III in the corpus. The carcinosarcoma consisted of tubular carcinoma and sarcomatous transformation of stroma from the carcinoma.

Adenocarcinoma, Papillary↗
PubMed1984

Carcinosarcoma of the esophagus with osseous and cartilagenous production. A combined study of keratin immunohistochemistry and electron microscopy.

A case of polypoid carcinosarcoma of the esophagus is presented. Histologically the bulk of the tumor consisted of a sarcomatous tissue having large foci of osseous and cartilagenous differentiation and infiltrating deeply the wall, whereas a superficially, invasive squamous cell carcinoma associated with in-situ carcinoma was located at the base and luminal surface of the polypoid tumor. Intermingling of the carcinomatous and sarcomatous elements was found only in areas where they appeared to be collided. Ultrastructurally the sarcomatous portion contained cells with fibroblastic features but with no typical epithelial characteristics. Immunoperoxidase staining of the paraffin-embedded histologic sections for keratin proteins revealed, however, some positive spindle cells indicative of epithelial nature in the sarcomatous area, but the great majority of the sarcoma cells were devoid of keratin. These combined findings strongly suggest that the sarcomatous component in our case of true carcinosarcoma is derived from mesenchymal transformation (metaplasia) of the squamous carcinoma cells. The findings were discussed in light of the previous pertinent literature.

Carcinoma in Situ↗
PubMed1992

True pulmonary carcinosarcoma (squamous cell carcinoma and chondrosarcoma). A case report.

True pulmonary carcinosarcoma (squamous cell carcinoma and chondrosarcoma) originating in the right lower lobe in a 62-year-old Japanese male is reported. The tumor, measuring 5.5 x 3.5 x 3.5 cm, was markedly necrotic and its apex protruded into the bronchial lumen. Light microscopy showed that the tumor was composed of squamous cell carcinoma with sarcomatous spindle or polygonal cell proliferation and true chondrosarcoma. Immunohistochemically, the cytoplasm of numerous cells of the squamous cell carcinoma component was stained with anti-cytokeratin (PKK 1) and the cytoplasmic membrane with anti-epithelial membrane antigen (EMA). Although sarcomatous regions were stained with anti-vimentin (vimentin) and no tumor cells were reactive for EMA, a few tumor cells were positive for PKK 1. The cytoplasm of numerous chondrosarcoma cells was positively stained for vimentin and S-100 protein. Based on these findings, we concluded that the present tumor was a true carcinosarcoma composed of squamous cell carcinoma with sarcomatous regions and true chondrosarcoma.

Aged↗
PubMed1995

Carcinosarcomas of the esophagus.

Two cases of carcinosarcoma of the esophagus are reported. Both were polypoid tumors occurring in the middle of the intrathoracic esophagus. The tumors were predominantly composed of spindle-shaped sarcoma cells with some squamous cell carcinomas (SCC). One tumor showed many bizarre giant cells with filamentous materials in the cytoplasm. Microscopical examination of both tumors revealed transition from SCC to sarcoma cells. Immunohistochemically, the spindle-shaped sarcoma cells in both tumors displayed a strongly positive immunoreaction to alpha-smooth muscle actin, as did the bizarre giant cells of one tumor to sarcomeric actin. SCC and a few spindle-shaped sarcoma cells near the SCC showed a positive immunoreaction to cytokeratin. Electron microscopy revealed that the spindle-shaped cells had many myofilaments with dense bodies and that the bizarre giant cells had sarcomere structures with Z-bands in their cytoplasm. These findings indicate that both tumors were carcinosarcomas of SCC and myogenic sarcoma. We considered that sarcoma cells might originate in SCC, representing its metaplastic differentiation, or that both SCC and sarcoma might originate in a pluripotent stem cell.

Aged↗
PubMed1995

Carcinosarcoma of the uterine body of mesonephric origin.

A case of carcinosarcoma of mesonephric origin in a 58 year old woman is reported. A cystic tumor with a solid area, measuring 14 cm in greatest diameter, was detected in the pelvic cavity by computerized tomography and ultrasound. Although it was diagnosed as an ovarian cancer for surgical removal, it was found to be entirely located in the myometrium of the left lateral wall of the uterine body and neither ovary was remarkable. Histologically the tumor was composed of epithelial and sarcomatous components. The former showed low papillary pattern, crowded solid nests and cords of cells, and focal tubular structures. The latter showed a solid growth pattern with differentiation to leiomyosarcoma. In the uterine cervix, a 1.2 cm mesonephric (Gartner's) cyst was found. Neither neoplastic lesions nor endometriosis were identified in the cervix, endometrium, fallopian tubes or ovaries. Based on the histologic features and the specific location of the tumor, the coexistence of Gartner's cyst, and the normal appearance of the endocervical mucosa as well as the endometrium, it was diagnosed as a mesonephric carcinosarcoma. The serum levels of carcinoembryonic antigen, CA125, CA19-9, and CA72-4 were within normal ranges in the clinical course. The patient died of disease 8 months after surgery.

Carcinosarcoma↗
PubMed1997

Gastric carcinosarcoma (sarcomatoid carcinoma) with rhabdomyoblastic and osteoblastic differentiation.

A rare case of carcinosarcoma (sarcomatoid carcinoma) with rhabdomyoblastic and osteoblastic differentiation occurring in the gastric remnant is reported. A 69-year-old Japanese man who had undergone a partial gastrectomy for a duodenal ulcer 30 years earlier, presented with anemia, epigastralgia, and an abdominal mass. The diagnosis of gastric carcinosarcoma was made based on the findings of endoscopic biopsies. The patient was thus scheduled to undergo a surgical operation, but he died of respiratory failure. At autopsy, a huge polypoid tumor measuring 20 x 18 x 8 cm was located on the greater curvature of the gastric remnant. Microscopically, the tumor consisted of intimately mixed tubular adenocarcinoma and heterologous mesenchymal elements containing rhabdomyosarcoma and osteosarcoma. Between these components, a morphological transition from the adenocarcinoma element to the sarcomatous element was observed. Ultrastructually, rhabdomyoblastic differentiation was confirmed in the sarcomatous areas. Immunocytochemical expressions of epithelial markers including epithelial membrane antigen and cytokeratins (35bH11 and 34bE12) were recognized not only in the carcinomatous cells but also in the sarcomatous cells. These findings suggest that carcinomatous cells appear to transform into cells with sarcomatous features.

Aged↗
PubMed2006

Lung carcinosarcoma with liposarcoma element: autopsy case.

Pulmonary carcinosarcoma, consisting of both carcinoma and sarcoma with a heterologous element, is a rare subtype, comprising approximately 0.3% of primary lung neoplasia. A 57-year-old man was admitted because of severe dyspnea. A tumor wholly occupying the right thorax was biopsied and diagnosed as pleomorphic sarcoma. The tumor did not respond to chemotherapy, and the patient died of respiratory failure and sepsis. At autopsy, pleomorphic sarcoma was histologically dominant and contained a liposarcoma element confirmed by histocytological and electron microscopic analysis. Adenocarcinoma component with papillary and tubular patterns was confined to the medial lesion of the right lower lobe (3x8 cm), which was found in the chest X-ray 3 years before admission, and had continuously merged with the sarcomatous lesion through the histological transition of both components. Aggressive and rapid growth of the sarcoma derived from the earlier adenocarcinoma became prevalent and contributed to the severe clinical outcome. This is the first documented case of primary lung carcinosarcoma with a liposarcoma element.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Carcinosarcoma of the bladder diverticulum and a review of the literature.

We report a carcinosarcoma within a bladder diverticulum together with a review of 18 previously reported cases of intradiverticular sarcomas and carcinosarcomas with respect to their clinical features, treatments and outcomes. Frequent deaths with intra-abdominal recurrences suggest the need for total cystectomy, rather than diverticulectomy.

Aged↗
PubMed2006

Esophageal carcinosarcoma with intramural metastasis.

A case of esophageal carcinosarcoma is described herein. A 58-year-old man presented with dysphagia and was admitted to our hospital. Imaging studies revealed a type 3 tumor in the upper intrathoracic esophagus with direct invasion to the left main bronchus. Analysis of a biopsy specimen revealed carcinosarcoma. The patient underwent esophageal bypass and chemoradiotherapy. Eight months after surgery, he died of esophago-bronchial fistula. Autopsy examination revealed liver metastasis, peritoneal dissemination and intramural metastasis. The sarcomatous component was predominant in the intramural and liver metastatic lesions.

Biopsy↗
PubMedDate not supplied

Carcinosarcoma-like mural nodule in intestinal-type mucinous ovarian of borderline malignancy: a case report.

Epithelial ovarian tumors of borderline malignancy are tumors with histologic features and biologic behavior between benign and frankly malignant epithelial ovarian neoplasms. To date, we cannot accurately predict the patients who are prone to an aggressive course of disease. Here, we present a 35-year-old patient with carcinosarcoma-like mural nodule in intestinal-type mucinous ovarian tumor of borderline malignancy. Foci of intraepithelial carcinoma (about 10%) without stromal invasion are also noted. Total hysterectomy, bilateral salpingo-oophorectomy, appendectomy, and omentectomy were performed, and the frozen pathology during operation showed mucinous tumor of borderline malignancy of left ovary on April 18, 2002. The patient was followed at our outpatient department for 19 months after operation and was free of the disease without any adjuvant chemotherapy. It is difficult to determine whether intestinal-type borderline mucinous tumors with intraepithelial carcinoma are associated with a worse prognosis compared with those with epithelial atypia alone due to disparate results in the published literature. In contrast, most patients with mural nodules of anaplastic carcinoma have had a malignant, often rapid, course. However, too few cases of carcinosarcoma-like mural nodule in mucinous tumor have been published to warrant a conclusion regarding their prognosis.

Adult↗
PubMed2006

Carcinosarcoma of the prostate.

We report the case of a 66-year-old man who was diagnosed as having prostatic adenocarcinoma with widespread skeletal metastases. After treatment with a luteinizing hormone-releasing hormone analog for one year, a second biopsy revealed transformation of the tumour into a carcinosarcoma with heterogeneous and unusual findings in the carcinomatous as well as the sarcomatous component. Among others, these included a papillary growth pattern and a liposarcomatous differentiation. The patient died 5 months after the diagnosis of carcinosarcoma.

Adenocarcinoma↗