[Carcinosarcoma and carcinoma. Analogies and differences. Primary and secondary stroma in carcinosarcoma and carcinoma].
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Carcinoma↗
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Polypoid carcinoma of the esophagus. A unifying term for "carcinosarcoma" and "pseudosarcoma".
Polypoid carcinomas with spindle-cell sarcomatous features have been designated either as carcinosarcoma or pseudosarcoma. The distinction between these two tumors has depended on the presence of "intermingling" of the carcinomatous and sarcomatous components in so-called carcinosarcoma. But unlike the carcinosarcoma, the sarcomatous component in pseudosarcoma has been considered benign. A polypoid tumor of the esophagus in a 57-year-old male was predominantly composed of spindle cell, sarcomatous cells. The presence of adjacent intraepithelial epidermoid carcinoma with transitional and ultrastructural features confirmed the epithelial origin of this tumor. Because of the absence of "intermingling," the primary tumor was considered to be a pseudosarcoma. However, our postmortem examination showed metastases composed of both carcinomatous and sarcomatous features. A review of the literature on carcinosarcomas and pseudosarcomas shows that only one case of pseudosarcoma reported by Hughes and Cruickshank showed a similar situation and indicates that the sarcomatous component in pseudosarcomas has the same metastatic potentiality as has been reported in carcinosarcomas. We conclude from these studies a basic similarity of the carcinosarcoma and pseudosarcoma. The term polypoid carcinoma is proposed for both these lesions.
Bronchial Fistula↗
[Malignant double tumor of the lung: endobronchial carcinosarcoma in the left and polypous squamous cell carcinoma in the right upper lobe].
According to MOORE, two types of carcinosarcoma in the lung may be distinguished: one with a peripheral and one with an endobronchial localization. The latter type is characterized by minimal local infiltration, absence of distant metastases and early symptomatology of bronchial obstruction. This report deals with the autopsy findings in a 67-year-old smoker in whom a typical endobronchial carcinosarcoma was found in the left upper lobe. In all the published cases, as well as in our patient, the epithelial part of the tumor was found to be a squamous cell carcinoma with varying grades of differentiation. On the other hand, the mesenchymal part has not been uniformly described. In the present case, it occurred as a spindle-cell shaped sarcoma. Morphologically, carcinosarcomas are to be distinguished from carcinomas associated with pseudosarcoma. Prognosis of successfully operated patients seems to be favourable. Survivals of up to 6 years without recurrence have been reported. In our patient the carcinosarcoma was associated with a polypoid squamous cell carcinoma in the right upper lobe. No other case with such a combination has been reported.
Aged↗
Association between pembrolizumab-based therapy exposure and survival outcomes in metastatic or recurrent uterine carcinosarcoma: a multi-center real-world study.
OBJECTIVE: To evaluate the association between exposure to pembrolizumab-based therapy in the post-platinum setting and survival outcomes in patients with metastatic or recurrent uterine carcinosarcoma. METHODS: In this retrospective study, patients with metastatic or recurrent uterine carcinosarcoma treated at three tertiary centers between January 2008 and April 2025 were included. Patients received various treatment modalities after recurrence or progression in the post-platinum setting. Survival outcomes were analyzed according to whether patients were exposed to pembrolizumab-based therapy after recurrence or progression. Survival after recurrence and overall survival were evaluated using Kaplan-Meier analyses and Cox proportional hazards models. Additional analyses using inverse probability of treatment weighting, doubly robust methods, and time-dependent Cox models were performed. RESULTS: A total of 147 patients were included, of whom 42 (28.6%) received pembrolizumab-based therapy in the post-platinum setting. In multi-variable analyses, pembrolizumab-based therapy exposure was independently associated with improved survival after recurrence (hazard ratio 0.44, 95% confidence interval 0.24 to 0.83, p = .01) and overall survival (hazard ratio 0.48; 95% confidence interval 0.26 to 0.89, p =.02). Positive peritoneal washing cytology was independently associated with poorer survival outcomes. In time-dependent Cox analyses using inverse probability of treatment weighting, pembrolizumab-based therapy exposure remained significantly associated with improved survival after recurrence (hazard ratio 0.56, 95% confidence interval 0.33 to 0.96, p =.035), whereas the association with overall survival was no longer statistically significant. CONCLUSIONS: Exposure to pembrolizumab-based therapy in the post-platinum setting was associated with improved survival after recurrence in patients with metastatic or recurrent uterine carcinosarcoma. These findings support the potential clinical relevance of pembrolizumab-based therapy in the post-platinum setting and warrant further prospective validation.
Aged↗
Endobronchial carcinosarcoma. A case with osteosarcoma of pulmonary invasive part, and a review with respect to prognosis.
A case of endobronchial carcinosarcoma is reported in which a small area of epidermoid carcinoma at the base of the partly necrotic, polypoid part of the tumor was found, and where the pulmonary invasive part consisted of osteosarcoma. To our knowledge such a case has not been published before. In the literature 23 cases of endobronchial carcinosarcoma were found. All but one of those alive at the time of diagnosis were considered operable. The first year survival rate of the reviewed and the reported cases was 36% of all or 42% of the resected cases. The figures for bronchial carcinoma are 33% or 62% of the resected cases. The pre- and post-operative mortality for endobronchial carcinosarcoma was 23%. Because follow-up was too short, the 5 year survival rate cannot be estimated. Features common to pulmonary sarcoma and pseudosarcoma of the upper respiratory tract are also discussed.
Aged↗
Oxygen diffusivity in tumor tissue (DS-carcinosarcoma) under temperature conditions within the range of 20--40 degrees C.
The O2 diffusion constants D and K of tumor tissue (DS-Carcinosarcoma in the rat kidney) were determined at temperatures of 20, 30, 37, and 40 degrees C. The following mean values were obtained for the conditions of 37 degrees C: D = 1.75-10(-5) cm2/s and K = 1.9-10(-5) mlO2/cm-min-atm. Within the range of 20-40 degrees C, temperature variations in tumor tissue cause changes in the O2 diffusion coefficient D of 2.0-2.5%/C and in the Krogh O2 diffusion constant K of 0.5-1.5%/C. The measured O2 diffusion constants for tumor tissue correspond to values of normal tissue with similar water content. This indicates that the insufficient O2 supply in DS-Carcinosarcoma is due not to unfavorable O2 diffusivity of the tumor tissue but rather to a decreased convective O2 transport and to insufficient capillarization. An analysis of O2 diffusion in DS-Carcinosarcoma tissue using the determined O2 diffusion constants lead to the result that, under the conditions of arterial normoxia and normocapnia, critical O2 supply conditions are to be expected when the intercapillary distance exceeds approximately 120 micrometer.
Animals↗
Pulmonary blastoma evolving into carcinosarcoma. A case study.
A rare lung tumor composed of contiguous foci of classical blastoma and carcinosarcoma with transitional features is described. Based on these observations and a review of the literature, we propose that pulmonary carcinosarcomas are composed of a heterogeneous population of tumors. This case supports the concept that blastomas are a distinctive subtype of carcinosarcomas. An unusual feature in the clinical presentation was the expectoration of an endobronchial portion of tumor.
Adolescent↗
C-type virus particles in urethan-induced pulmonary and renal carcinomas, in cell-graft-transmitted carcinosarcomas, and in filtrate-induced lymphomas in mice.
Repeated injections of urethan into suckling BALB/c mice induced multiple papillary adenocarcinomas in the lungs and kidneys. When the pulmonary tumors were transplanted i.p. by cell graft into 6 suckling BALB/c mice, they induced disseminated carcinosarcomas within the peritoneal cavity in all inoculated animals. Tumors resulting from the transplantation of tumor cells were used for preparation of filtered extracts. The filtrates were inoculated into 6 suckling BALB/c mice and induced generalized malignant lymphomas in all animals. The primary urethan-induced pulmonary and renal tumors, the carcinosarcomas that resulted from i.p. cell transfer, and also the generalized malignant lymphomas induced by inoculation of filtered extracts contained C-type virus particles. Theoretically, it could be assumed that both the primary urethan-induced pulmonary and renal tumors, as well as the cell-graft-induced peritoneal carcinosarcomas, contained the C-type virus particles as passengers, not necessarily related etiologically to the tumors in which they were found. It is quite likely, however, that these virus particles were etiologically related to the filtrate-induced malignant lymphomas in which they were also found.
Adenocarcinoma, Papillary↗
Carcinosarcomas and mixed mesodermal tumors of the ovary: a clinicopathologic study of six cases.
A clinicopathologic study of three ovarian carcinosarcomas and three mixed mesodermal tumors of the ovary is presented. None of the patients survived for more than 1 year, irrespective of chemotherapeutic treatment or the extent of surgery. No prognostic differences were noted between the histologic patterns of varying tumor sizes of carcinosarcomas and mixed mesodermal tumors. The association of these two entities with other neoplasms of Müllerian nature suggests a multicentric tumor response of Müllerian tract derivatives. The necessity of adequate sampling, both for correct diagnosis and to exclude the possibility of teratoma (which behaves in a more benign fashion), is emphasized.
Aged↗
True carcinosarcoma of the larynx: a case report.
A case of true carcinosarcoma of the larynx occurring in a 55-year-old male is reported. The two components of this very rare tumour are pleomorphic rhabdomyosarcoma and squamous cell carcinoma. A review of the literature has revealed only two authentic cases of true carcinosarcomas.
Carcinoma, Squamous Cell↗
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↗
[Bronchopulmonary carcinosarcomas. Therapeutic indications].
The authors make an analysis of 11 cases of carcinosarcoma that have underwent surgery in the Clinic of Thoracic Surgery. The authors stress the rarity of these cases in their statistics. Only 11 carcinosarcomas have been identified out of a total of 2.500 cases of bronchopulmonary tumors operated in the Clinic. The difficulty of pre-operatory diagnosis is also stressed. Indications for surgical treatment are mandatory in all cases, even when the expected effects are palliative.
Adult↗
[Demonstration of tumor inhibiting properties of a strongly immunostimulating low-molecular weight substance. Comparative studies with ifosfamide on the immuno-labile DS carcinosarcoma. Stimulation of the autoimmune activity for approx. 20 days by BA 1, a N-(2-cyanoethylene)-urea. Novel prophylactic possibilities].
A report is given on the recent discovery of outstanding immunological properties in BA 1 [N-(2-cyanoethylene)-urea] having a (low) molecular mass M = 111.104. Experiments in 214 DS carcinosarcoma bearing Wistar rats have shown that BA 1, at a dosage of only about 12 percent LD50 (150 mg kg) and negligible lethality (1.7 percent), results in a recovery rate of 40 percent without hyperglycemia and, in one test, of 80 percent with hyperglycemia. Under otherwise unchanged conditions the reference substance ifosfamide (IF) -- a further development of cyclophosphamide -- applied without hyperglycemia in its most efficient dosage of 47 percent LD50 (150 mg kg) brought about a recovery rate of 25 percent at a lethality of 18 percent. (Contrary to BA 1, 250-min hyperglycemia caused no further improvement of the recovery rate.) However this comparison is characterized by the fact that both substances exhibit two quite different (complementary) mechanisms of action. Leucocyte counts made after application of the said cancerostatics and dosages have shown a pronounced stimulation with BA 1 and with ifosfamide, the known suppression in the post-therapeutic interval usually found with standard cancerostatics. In combination with the cited plaque test for BA 1, blood pictures then allow conclusions on the immunity status. Since IF can be taken as one of the most efficient cancerostatics--there is no other chemotherapeutic known up to now that has a more significant effect on the DS carcinosarcoma in rats -- these findings are of special importance. Finally, the total amount of leucocytes and lymphocytes as well as their time behaviour was determined from the blood picture of tumour-free rats after i.v. application of BA 1. The thus obtained numerical values clearly show that further research work on the prophylactic use of this substance seems to be necessary and very promising.
Animals↗
[Sarcomalike patterns in laryngeal carcinoma (pseudosarcoma, carcinosarcoma, spindle-cell-carcinoma, pleomorphic carcioma (author's transl)].
Report on 5 cases of so called carcinosarcomas of the larynx and hypopharynx and review of literature. These polypoid tumors have a small epidermoid carcinomatous part and a major part with sarcoma like appearance. The sarcomatoid tissue resembles to fibrosarcomas or some undifferentiated pleomorphic sarcoma. Observations of a gradual transition from the epithelial tumor cells to cells with a mesodermal appearance show that these tumors are varieties of squamous cell carcinomas (spindle cell or pleomorphic variety) and not "combination"--or "collision-tumors", "carcinosarcomas" or "seudosarcomas". These tumors appear in the larynx predominantly in man, at the same sites and in the same ageclasses as common squamous cell cancers and are not less malignant. The sarcomatoid tissue can arise at the beginning of the disease or at a later stage it can appear or disappear after operation or irradiation. The reason for this change of cellular structure is unknown.
Aged↗
[Carcinosarcoma of the uterus and ovaries].
It was established on the material of 15 observations that carcinosarcomas represented a distinct group of rarely occurring malignancies. Among malignant tumors of the body of the uterus, cervix and ovary they comprise 1.5%, 0.03% and 0.17%, respectively. The details of the structure of two tumor components, epithelial and mesenchymal, are described. A special group of carcinosarcomas of the body of the uterus and ovary consisting of three tumor germs, adenoacanthocarcinosarcoma, is distinguished.
Adenocarcinoma↗
Circadian variations in 32P uptake of DMBA-induced mammary tumour and Walker carcinosarcoma in rats.
The 32P uptake in a mammary tumour induced by DMBA and in the Walker 256 carcinosarcoma was measured by external GM -tubes. The uptake was significantly higher than in the skin. During exposure to a synchronized light regime a circadian variation was present in the 32P uptake of the hormone-dependent DMBA-induced tumour. The maximal 32P uptake was in the dark period, in which the highest temperature in the tumour has also been found (Møoller and Bojsen, 1975). In the hormone-independent Walker 256 carcinosarcoma there was no periodicity in 32P uptake. No variation in 32P uptake was registered in the skin of normal controls or in tumour-bearing rats.
9,10-Dimethyl-1,2-benzanthracene↗
Carcinosarcoma and mixed müllerian tumors of the fallopian tube: report of four cases.
We report a 74-year-old woman with malignant mixed müllerian tumor and three women, aged 47, 58, and 76 years, with carcinosarcomas, all primary in the fallopian tube. The tumors grew predominantly intraluminally and were associated with hydrosalpinx. All four patients underwent salpingectomy. Two of them received radiation therapy; one died within 9 months because of the tumor and the second is well 2 years after diagnosis. Of the two women without additional therapy, one is alive with tumor 53 months postoperatively and the other is well 1 year after surgery. Available data suggest that these neoplasms are relatively radioresistant and that their prognosis correlates best with local invasiveness.
Aged↗
Carcinosarcoma of the renal pelvis.
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.
Carcinoma, Transitional Cell↗