BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type i...BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.展开更多
Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting...Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.展开更多
BACKGROUND Carcinosarcomas of the common bile duct(CBD)are an extremely rare finding in the clinical setting.Based on a review of 12 literatures,3 cases had the imaging features of ossification.Carcinosarcomas are pro...BACKGROUND Carcinosarcomas of the common bile duct(CBD)are an extremely rare finding in the clinical setting.Based on a review of 12 literatures,3 cases had the imaging features of ossification.Carcinosarcomas are prone to distant metastasis,as they possess clinical features of both carcinoma and sarcoma,and generally have with a poor prognosis.Due to the small number of cases reported,clinical experience in the diagnosis and treatment of the disease is lacking.CASE SUMMARY The patient was a 75-year-old woman who had experienced recurrent chills with nausea and vomiting for 3 mo.Computed tomography,magnetic resonance imaging,endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography led to the diagnosis of malignant tumor of the CBD.The patient ultimately underwent cholecystectomy,CBD resection,and choledochojejunostomy.Postoperative pathological examination revealed carcinosarcoma of the CBD,and the latest follow-up showed that the patient is recovering well.Based on previous case reports,some carcinosarcoma has ossification characteristics in imaging.If it is misdiagnosed as biliary calculi,the use of laser lithotripsy in surgery may lead to tumor diffusion.Choledochoscopy and narrow band staining of mucosa are very important for diagnosis.CONCLUSION We herein present a rare case of carcinosarcomas of the CBD,we found the tumours may have imaging features of polypoid growth and ossification only when the sarcomal components are bone differentiation,while show soft tissue shadow when non bone differentiation.Confirmation of diagnosis depends greatly upon postoperative pathological examination and the adjuvant treatment has not been established,which leads to the poor prognosis.展开更多
BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteo...BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteosarcoma as the tumor components.The clinicopathological characteristics,treatment,and prognosis are discussed in conjunction with the literature.CASE SUMMARY A 48-year-old man presented with a complaint of a mass in the right parotid region.Osteosarcoma was first considered for assessment by fine-needle aspiration cytology.Physical examination revealed a mass measuring approximately 4 cm×3.5 cm×3 cm.The mass,the whole lobe of the right parotid gland,and the right mandible were completely removed during surgery.Postoperative histopathology confirmed carcinosarcoma of the salivary gland.CONCLUSION A definite diagnosis of salivary gland carcinosarcoma can only be obtained after complete surgical resection.展开更多
Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide sup...Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.展开更多
Carcinosarcoma,which comprises less than one percent of all gall bladder neoplasms,is characterized by the presence of variable proportions of carcinomatous and sarcomatous elements.Recently,several reports have descr...Carcinosarcoma,which comprises less than one percent of all gall bladder neoplasms,is characterized by the presence of variable proportions of carcinomatous and sarcomatous elements.Recently,several reports have described patients suffering from carcinosarcoma of the gall bladder.However,there are no large studies regarding the clinicopathologic features,therapeutic management,and surgical outcome of this disease because the number of patients who undergo resection of gall bladder carcinosarcoma at a single institution is limited.A Medline search was performed using the keywords 'gall bladder' and 'carcinosarcoma'.Additional articles were obtained from references within the papers identified by the Medline search.Optimal adjuvant chemotherapy and/or radiotherapy protocols for carcinosarcoma of the gall bladder have not been established.Curative surgical resection offers the only chance for long-term survival from this disease.The outcome of 36 patients who underwent surgical resection for carcinosarcoma of the gall bladder was poor;the 3-year overall survival rate was only 31.0% and the median survival time was 7.0 mo.Since the postoperative prognosis of carcinosarcoma of the gall bladder is worse than that of adenocarcinoma,new adjuvant chemotherapies and/or radiation techniques are essential for improvement of surgical outcome.展开更多
Carcinosarcoma of the pancreas is an extremely rare tumor and has a dismal prognosis. To the best of our knowledge, the histopathological features of the lesion have been illustrated in the literature but to date no r...Carcinosarcoma of the pancreas is an extremely rare tumor and has a dismal prognosis. To the best of our knowledge, the histopathological features of the lesion have been illustrated in the literature but to date no reported cases have been documented on imaging characteristics. We report a female case of pancreatic carcinosarcoma presenting as a mucinous cystadenoma on computed tomography(CT). We also summarize the CT characteristics according to the appended CTimages in the reported cases. This is the first report of CT features of pancreatic carcinosarcoma in the English literature.展开更多
Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confir...Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confirmed by pathology following surgical resection. Using contrast-enhanced ultrasonography, the tumor showed peripheral nodular hyperenhancement in the arterial phase with two feeding arterial vessels and a large internal non-enhancing portion in the center. The peripheral nodular portion of the tumor showed hypoenhancement in the later phase.展开更多
We report an extremely rare case where a mesenchymal differentiation, especially embryonal sarcoma, was demonstrated in cholangiocarcinoma. At autopsy, a yellowish-white tumor （15 cm× 12 cm） was found in the ri...We report an extremely rare case where a mesenchymal differentiation, especially embryonal sarcoma, was demonstrated in cholangiocarcinoma. At autopsy, a yellowish-white tumor （15 cm× 12 cm） was found in the right hepatic lobe, and there were several daughter nodules in both hepatic lobes. Histologically, most of the main tumor and all of the daughter nodules examined showed sarcomatous changes （spindle cells, pleomorphic ceils and hyalization）. Histologic examination of a part of the main tumor disclosed a focus of adenocarcinoma within the tumor. The frequent transitions between the adenocarcinomatous areas and the sarcomatous areas suggested that sarcomatous transformation occurred in the cholangiocarcinoma and then spread rapidly. Immunohistochemically, the adenocarcinomatous elements were positive for cytokeratin, carcinoembryonic antigen （CEA） and epithelial membrane antigen, and negative in the sarcomatous cells. Vimentin was positive only in the sarcomatous elements. The findings of the present case support the view that carcinosarcomas represent carcinomas that develop sarcomatous elements via metaplasia of the epithelial element.展开更多
Esophageal carcinosarcoma is a rare malignant tumor composing of both carcinomatous and sarcomatous elements. Endoscopic therapy is less invasive and may represent an alternative to esophagectomy for superf icial esop...Esophageal carcinosarcoma is a rare malignant tumor composing of both carcinomatous and sarcomatous elements. Endoscopic therapy is less invasive and may represent an alternative to esophagectomy for superf icial esophageal carcinosarcoma. Here, we report a 61-year-old male who was diagnosed as esophageal carcinosarcoma and underwent endoscopic polypectomy with well tolerance and favorable prognosis. We also present a brief review of the literature.展开更多
Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of...Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of deformed stomach was obtained that measured 200 mm×150 mm×100 mm. A 150 mm×100 mm× 50 mm exophytic tumoral mass (Borrmann typeⅠ) was found,which involved the posterior wall from the cardia to the antrum. Histopathologically,a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia,with interposed fascicles of fusiform atypical cells and numerous large,rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18,epithelial membrane antigen,carcinoembryonic antigen,chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively,and the patient died 4 mo later. A review of the available literature is also presented.展开更多
BACKGROUND Carcinosarcoma(spindle cell carcinoma) of the esophagus is an extremely rare event;the etiology and origins of this neoplasm have not yet been determined.Epithelial-mesenchymal transition(EMT) has been asso...BACKGROUND Carcinosarcoma(spindle cell carcinoma) of the esophagus is an extremely rare event;the etiology and origins of this neoplasm have not yet been determined.Epithelial-mesenchymal transition(EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor.CASE SUMMARY We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-Ⅱc lesions located 35 cm from the incisors toward the esophago-gastric junction.Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-Ⅱc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adenocarcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor.The patient was diagnosed with multiple carcinosarcomas, staged at pT1b(SM3),pN1(#110, #7), cM0, Stage Ⅱ(sarcomatous metastasis to the lymph nodes).Spindle cells did not express E-cadherin but were positive for EMT markers,including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery.CONCLUSION This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT.展开更多
BACKGROUND:Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carci- nomatous and sarcomatous elements.Reports on risk factors, epidemiology,and pathogenesis of the tumor as wel...BACKGROUND:Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carci- nomatous and sarcomatous elements.Reports on risk factors, epidemiology,and pathogenesis of the tumor as well as the experience in its treatment are limited. METHOD:We present a case of primary carcinosarcoma of the liver in a 69-year-old man who complained of right hypochondrial pain and weight loss for two months. RESULTS:Magnetic resonance imaging revealed a 14×12 cm mass in segments 7-8 and 4 of the liver with vena hepatica invasion.An ultrasonography-guided biopsy showed osteoid tissue without osteoblastic rimming.Vascular structures accompanied the osteoid tissue.The patient underwent surgery after a diagnosis of hemangioma.Intraoperative frozen sections revealed a carcinosarcoma associated with an osteosarcoma and cholangiocellular carcinoma components. CONCLUSIONS:Preoperative diagnosis of this rare primary hepatic malignant tumor may be difficult by biopsy owing to intratumoral heterogeneity.Highly mature areas of the osteosarcomatous component may lead to misdiagnosis of metaplastic bone tissue.Clinicopathologic features of this rare entity are discussed.展开更多
Sarcomatoid carcinoma is a rare tumor with a poor prognosis,otherwise known as carcinosarcoma.Gastrointestinal origin is very rare and only a limited number of anal carcinosarcomas have been reported in the literature...Sarcomatoid carcinoma is a rare tumor with a poor prognosis,otherwise known as carcinosarcoma.Gastrointestinal origin is very rare and only a limited number of anal carcinosarcomas have been reported in the literature.The management of this rare cancer type is controversial.The aim of this case report was to conf irm that by combining treatment modalities we can achieve long disease free intervals.Concomitant chemoradiotherapy led to a good partial response and this was followed by a consolidation surgical endo-anal excision.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Ovarian carcinosarcoma composed of high-grade carcinoma and sarcoma is an extremely rare neoplasm and typically occu...<div style="text-align:justify;"> <span style="font-family:Verdana;">Ovarian carcinosarcoma composed of high-grade carcinoma and sarcoma is an extremely rare neoplasm and typically occurs in postmenopausal women aged over 60 years. A 73-year-old female, gravida three para three, presented to our hospital with right lower abdominal pain. Right pelvic solid tumor with ascites was detected on pelvic ultrasound examination. She underwent hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy, but the tumor had invaded to the right ureter, and some fragile tumor could not be taken (sub-optimal surgery). On the imprint and ascitic cytology specimens during operation, atypical cells suggestive of adenocarcinoma and spindle atypical cells with immunocytochemically vimentin positive were found. The resected tumor was histopathologically carcinosarcoma consisted of serous adenocarcinoma, chondrosarcoma and fibrosarcoma. Immunohistochemical analysis revealed that adenocarcinoma cells were positive for AE1/AE3 and fibrosarcoma cells stained with vimentin. The final diagnosis was the right ovarian carcinosarcoma (stage pT3CNxMx). Microsatellite instability was stable and BRCA1/2 mutations could not be found in the carcinosarcoma cells. The patient was given four cycles of chemotherapy with paclitaxel, carboplatin and bevacizumab regimen, and thereafter she was treated with the ifosfamide and cisplatin because of slight elevation of serum CA125.</span> </div>展开更多
PRIMARY pulmonary sarcomatoid carcinoma （PSC）is a rare condition, approximately accounting for0.1%-0.4% of all lung malignancies.1 PSCsconsist of 5 major histological variants accordingto 2004 WHO classification： p...PRIMARY pulmonary sarcomatoid carcinoma （PSC）is a rare condition, approximately accounting for0.1%-0.4% of all lung malignancies.1 PSCsconsist of 5 major histological variants accordingto 2004 WHO classification： pleomorphic carcinoma,spindle cell carcinoma, giant cell carcinoma, carcinosarcoma.展开更多
Gastric carcinosarcomas are rare morphologically biphasic tumors, consisting of carcinoma and sarcoma components, with a poor clinical course.Here we report the case of a 70-year-old man with advanced Borrmann type Ⅲ...Gastric carcinosarcomas are rare morphologically biphasic tumors, consisting of carcinoma and sarcoma components, with a poor clinical course.Here we report the case of a 70-year-old man with advanced Borrmann type Ⅲ carcinosarcoma arising from the upper body of the stomach with extensive lymph node metastasis who underwent a total, but palliative, gastrectomy.Histology showed the tumor consisted of a biphasic structure of tubular adenocarcinoma and spindle cellsarcoma.Immunohistochemistry revealed sarcoma cells expressing c-kit(CD117) and CD34, which are criteria for gastrointestinal stromal tumors.Nine months after the surgical operation, tumor metastases had extended to the hepatohilar, retroperitoneal and mediastinal lymph nodes.Radiation therapy of 50 Gy markedly decreased the size of each of these nodes and reduced the risk of respiratory complications and jaundice.However, the patient died of respiratory failure due to bronchopneumonia with multiple lung metastases 22 mo after resection.Autopsy revealed severe necrosis in most of the lymph nodes with tumor metastases.Radiation therapy combined with gastrectomy should be considered to improve survival in patients with gastric carcinosarcomas that express c-kit.展开更多
Carcinosarcoma is a rare entity of neoplasm especially in gallbladder, with collision elements of both adenocarcinomatous and sarcomatous component. Its clinical behavior is even worse than that of carcinoma, yet few ...Carcinosarcoma is a rare entity of neoplasm especially in gallbladder, with collision elements of both adenocarcinomatous and sarcomatous component. Its clinical behavior is even worse than that of carcinoma, yet few cases have been reported to date. A male patient 75 years old admitted in our hospital was finally diagnosed as carcinosarcoma. He underwent surgical resection and adjuvant chemotherapy with oxaliplatin-containing regimen for six cycles. The patient achieved a long-time survival of 30 months.展开更多
Carcinosarcoma of the uterine cervix are very rare malignancy of the female reproductive tract with poor prognosis. Only fifty cases have been reported in literature until 2013. We report a 49 years old Para 7 + 3 pre...Carcinosarcoma of the uterine cervix are very rare malignancy of the female reproductive tract with poor prognosis. Only fifty cases have been reported in literature until 2013. We report a 49 years old Para 7 + 3 presenting with vaginal bleeding, offensive discharge with intermittent abdominal pain. On examination an impression of a cervical polyp was made. She had total abdominal hysterectomy and bilateral salpingoophorectomy. The histological diagnosis of carcinosarcoma of the uterine cervix was made. She had chemoradiation therapy as adjuvant therapy in view of the diagnosis. Although cancer of the cervix is the second commonest cancer worldwide and the leading cause of cancer death in women, this particular histological variant is very rare, as such no standard protocol of management developed for it yet and it carries a very poor prognosis.展开更多
Lung carcinosarcoma is a rare pulmonary mixed malignant tumor From November 1979 to Sept. 1992,among 4,251 cases of pulmonary malignant tumor operated in our department 15 were lung carcinosarcoma (0.35%). Pneumonecto...Lung carcinosarcoma is a rare pulmonary mixed malignant tumor From November 1979 to Sept. 1992,among 4,251 cases of pulmonary malignant tumor operated in our department 15 were lung carcinosarcoma (0.35%). Pneumonectomy was done in 6 patients,lobectomy in 8, thoracotomy in 1. Pathologically,squamous carcinoma with fibrosarcoma in 1,adenocarcinoma with fibrosarcoma in 7, adenocarcinoma with chondrosarcoma in 1, and small-cell carcinoma with chondrosarcoma in 1. There was no operation death.Upon follow up,, the 1-, 3-, 5-, and 7-year survival rates were 66.7%, 53.3./., 42.9% and 2/7, respectively. The longest survival was 97 months. The histologica origin,the relationship between pathological findings and clinical features and the diagnosis, treatment and prognosis are discussed.展开更多
文摘BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.
文摘Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.
文摘BACKGROUND Carcinosarcomas of the common bile duct(CBD)are an extremely rare finding in the clinical setting.Based on a review of 12 literatures,3 cases had the imaging features of ossification.Carcinosarcomas are prone to distant metastasis,as they possess clinical features of both carcinoma and sarcoma,and generally have with a poor prognosis.Due to the small number of cases reported,clinical experience in the diagnosis and treatment of the disease is lacking.CASE SUMMARY The patient was a 75-year-old woman who had experienced recurrent chills with nausea and vomiting for 3 mo.Computed tomography,magnetic resonance imaging,endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography led to the diagnosis of malignant tumor of the CBD.The patient ultimately underwent cholecystectomy,CBD resection,and choledochojejunostomy.Postoperative pathological examination revealed carcinosarcoma of the CBD,and the latest follow-up showed that the patient is recovering well.Based on previous case reports,some carcinosarcoma has ossification characteristics in imaging.If it is misdiagnosed as biliary calculi,the use of laser lithotripsy in surgery may lead to tumor diffusion.Choledochoscopy and narrow band staining of mucosa are very important for diagnosis.CONCLUSION We herein present a rare case of carcinosarcomas of the CBD,we found the tumours may have imaging features of polypoid growth and ossification only when the sarcomal components are bone differentiation,while show soft tissue shadow when non bone differentiation.Confirmation of diagnosis depends greatly upon postoperative pathological examination and the adjuvant treatment has not been established,which leads to the poor prognosis.
基金Science and Technology Program of Sichuan Province,China,No.2022YFS0289.
文摘BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteosarcoma as the tumor components.The clinicopathological characteristics,treatment,and prognosis are discussed in conjunction with the literature.CASE SUMMARY A 48-year-old man presented with a complaint of a mass in the right parotid region.Osteosarcoma was first considered for assessment by fine-needle aspiration cytology.Physical examination revealed a mass measuring approximately 4 cm×3.5 cm×3 cm.The mass,the whole lobe of the right parotid gland,and the right mandible were completely removed during surgery.Postoperative histopathology confirmed carcinosarcoma of the salivary gland.CONCLUSION A definite diagnosis of salivary gland carcinosarcoma can only be obtained after complete surgical resection.
文摘Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.
文摘Carcinosarcoma,which comprises less than one percent of all gall bladder neoplasms,is characterized by the presence of variable proportions of carcinomatous and sarcomatous elements.Recently,several reports have described patients suffering from carcinosarcoma of the gall bladder.However,there are no large studies regarding the clinicopathologic features,therapeutic management,and surgical outcome of this disease because the number of patients who undergo resection of gall bladder carcinosarcoma at a single institution is limited.A Medline search was performed using the keywords 'gall bladder' and 'carcinosarcoma'.Additional articles were obtained from references within the papers identified by the Medline search.Optimal adjuvant chemotherapy and/or radiotherapy protocols for carcinosarcoma of the gall bladder have not been established.Curative surgical resection offers the only chance for long-term survival from this disease.The outcome of 36 patients who underwent surgical resection for carcinosarcoma of the gall bladder was poor;the 3-year overall survival rate was only 31.0% and the median survival time was 7.0 mo.Since the postoperative prognosis of carcinosarcoma of the gall bladder is worse than that of adenocarcinoma,new adjuvant chemotherapies and/or radiation techniques are essential for improvement of surgical outcome.
文摘Carcinosarcoma of the pancreas is an extremely rare tumor and has a dismal prognosis. To the best of our knowledge, the histopathological features of the lesion have been illustrated in the literature but to date no reported cases have been documented on imaging characteristics. We report a female case of pancreatic carcinosarcoma presenting as a mucinous cystadenoma on computed tomography(CT). We also summarize the CT characteristics according to the appended CTimages in the reported cases. This is the first report of CT features of pancreatic carcinosarcoma in the English literature.
基金Supported by The National Natural Science Foundation of China,No.81171361
文摘Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confirmed by pathology following surgical resection. Using contrast-enhanced ultrasonography, the tumor showed peripheral nodular hyperenhancement in the arterial phase with two feeding arterial vessels and a large internal non-enhancing portion in the center. The peripheral nodular portion of the tumor showed hypoenhancement in the later phase.
文摘We report an extremely rare case where a mesenchymal differentiation, especially embryonal sarcoma, was demonstrated in cholangiocarcinoma. At autopsy, a yellowish-white tumor （15 cm× 12 cm） was found in the right hepatic lobe, and there were several daughter nodules in both hepatic lobes. Histologically, most of the main tumor and all of the daughter nodules examined showed sarcomatous changes （spindle cells, pleomorphic ceils and hyalization）. Histologic examination of a part of the main tumor disclosed a focus of adenocarcinoma within the tumor. The frequent transitions between the adenocarcinomatous areas and the sarcomatous areas suggested that sarcomatous transformation occurred in the cholangiocarcinoma and then spread rapidly. Immunohistochemically, the adenocarcinomatous elements were positive for cytokeratin, carcinoembryonic antigen （CEA） and epithelial membrane antigen, and negative in the sarcomatous cells. Vimentin was positive only in the sarcomatous elements. The findings of the present case support the view that carcinosarcomas represent carcinomas that develop sarcomatous elements via metaplasia of the epithelial element.
文摘Esophageal carcinosarcoma is a rare malignant tumor composing of both carcinomatous and sarcomatous elements. Endoscopic therapy is less invasive and may represent an alternative to esophagectomy for superf icial esophageal carcinosarcoma. Here, we report a 61-year-old male who was diagnosed as esophageal carcinosarcoma and underwent endoscopic polypectomy with well tolerance and favorable prognosis. We also present a brief review of the literature.
文摘Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of deformed stomach was obtained that measured 200 mm×150 mm×100 mm. A 150 mm×100 mm× 50 mm exophytic tumoral mass (Borrmann typeⅠ) was found,which involved the posterior wall from the cardia to the antrum. Histopathologically,a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia,with interposed fascicles of fusiform atypical cells and numerous large,rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18,epithelial membrane antigen,carcinoembryonic antigen,chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively,and the patient died 4 mo later. A review of the available literature is also presented.
文摘BACKGROUND Carcinosarcoma(spindle cell carcinoma) of the esophagus is an extremely rare event;the etiology and origins of this neoplasm have not yet been determined.Epithelial-mesenchymal transition(EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor.CASE SUMMARY We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-Ⅱc lesions located 35 cm from the incisors toward the esophago-gastric junction.Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-Ⅱc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adenocarcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor.The patient was diagnosed with multiple carcinosarcomas, staged at pT1b(SM3),pN1(#110, #7), cM0, Stage Ⅱ(sarcomatous metastasis to the lymph nodes).Spindle cells did not express E-cadherin but were positive for EMT markers,including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery.CONCLUSION This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT.
文摘BACKGROUND:Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carci- nomatous and sarcomatous elements.Reports on risk factors, epidemiology,and pathogenesis of the tumor as well as the experience in its treatment are limited. METHOD:We present a case of primary carcinosarcoma of the liver in a 69-year-old man who complained of right hypochondrial pain and weight loss for two months. RESULTS:Magnetic resonance imaging revealed a 14×12 cm mass in segments 7-8 and 4 of the liver with vena hepatica invasion.An ultrasonography-guided biopsy showed osteoid tissue without osteoblastic rimming.Vascular structures accompanied the osteoid tissue.The patient underwent surgery after a diagnosis of hemangioma.Intraoperative frozen sections revealed a carcinosarcoma associated with an osteosarcoma and cholangiocellular carcinoma components. CONCLUSIONS:Preoperative diagnosis of this rare primary hepatic malignant tumor may be difficult by biopsy owing to intratumoral heterogeneity.Highly mature areas of the osteosarcomatous component may lead to misdiagnosis of metaplastic bone tissue.Clinicopathologic features of this rare entity are discussed.
文摘Sarcomatoid carcinoma is a rare tumor with a poor prognosis,otherwise known as carcinosarcoma.Gastrointestinal origin is very rare and only a limited number of anal carcinosarcomas have been reported in the literature.The management of this rare cancer type is controversial.The aim of this case report was to conf irm that by combining treatment modalities we can achieve long disease free intervals.Concomitant chemoradiotherapy led to a good partial response and this was followed by a consolidation surgical endo-anal excision.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Ovarian carcinosarcoma composed of high-grade carcinoma and sarcoma is an extremely rare neoplasm and typically occurs in postmenopausal women aged over 60 years. A 73-year-old female, gravida three para three, presented to our hospital with right lower abdominal pain. Right pelvic solid tumor with ascites was detected on pelvic ultrasound examination. She underwent hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy, but the tumor had invaded to the right ureter, and some fragile tumor could not be taken (sub-optimal surgery). On the imprint and ascitic cytology specimens during operation, atypical cells suggestive of adenocarcinoma and spindle atypical cells with immunocytochemically vimentin positive were found. The resected tumor was histopathologically carcinosarcoma consisted of serous adenocarcinoma, chondrosarcoma and fibrosarcoma. Immunohistochemical analysis revealed that adenocarcinoma cells were positive for AE1/AE3 and fibrosarcoma cells stained with vimentin. The final diagnosis was the right ovarian carcinosarcoma (stage pT3CNxMx). Microsatellite instability was stable and BRCA1/2 mutations could not be found in the carcinosarcoma cells. The patient was given four cycles of chemotherapy with paclitaxel, carboplatin and bevacizumab regimen, and thereafter she was treated with the ifosfamide and cisplatin because of slight elevation of serum CA125.</span> </div>
文摘PRIMARY pulmonary sarcomatoid carcinoma （PSC）is a rare condition, approximately accounting for0.1%-0.4% of all lung malignancies.1 PSCsconsist of 5 major histological variants accordingto 2004 WHO classification： pleomorphic carcinoma,spindle cell carcinoma, giant cell carcinoma, carcinosarcoma.
文摘Gastric carcinosarcomas are rare morphologically biphasic tumors, consisting of carcinoma and sarcoma components, with a poor clinical course.Here we report the case of a 70-year-old man with advanced Borrmann type Ⅲ carcinosarcoma arising from the upper body of the stomach with extensive lymph node metastasis who underwent a total, but palliative, gastrectomy.Histology showed the tumor consisted of a biphasic structure of tubular adenocarcinoma and spindle cellsarcoma.Immunohistochemistry revealed sarcoma cells expressing c-kit(CD117) and CD34, which are criteria for gastrointestinal stromal tumors.Nine months after the surgical operation, tumor metastases had extended to the hepatohilar, retroperitoneal and mediastinal lymph nodes.Radiation therapy of 50 Gy markedly decreased the size of each of these nodes and reduced the risk of respiratory complications and jaundice.However, the patient died of respiratory failure due to bronchopneumonia with multiple lung metastases 22 mo after resection.Autopsy revealed severe necrosis in most of the lymph nodes with tumor metastases.Radiation therapy combined with gastrectomy should be considered to improve survival in patients with gastric carcinosarcomas that express c-kit.
文摘Carcinosarcoma is a rare entity of neoplasm especially in gallbladder, with collision elements of both adenocarcinomatous and sarcomatous component. Its clinical behavior is even worse than that of carcinoma, yet few cases have been reported to date. A male patient 75 years old admitted in our hospital was finally diagnosed as carcinosarcoma. He underwent surgical resection and adjuvant chemotherapy with oxaliplatin-containing regimen for six cycles. The patient achieved a long-time survival of 30 months.
文摘Carcinosarcoma of the uterine cervix are very rare malignancy of the female reproductive tract with poor prognosis. Only fifty cases have been reported in literature until 2013. We report a 49 years old Para 7 + 3 presenting with vaginal bleeding, offensive discharge with intermittent abdominal pain. On examination an impression of a cervical polyp was made. She had total abdominal hysterectomy and bilateral salpingoophorectomy. The histological diagnosis of carcinosarcoma of the uterine cervix was made. She had chemoradiation therapy as adjuvant therapy in view of the diagnosis. Although cancer of the cervix is the second commonest cancer worldwide and the leading cause of cancer death in women, this particular histological variant is very rare, as such no standard protocol of management developed for it yet and it carries a very poor prognosis.
文摘Lung carcinosarcoma is a rare pulmonary mixed malignant tumor From November 1979 to Sept. 1992,among 4,251 cases of pulmonary malignant tumor operated in our department 15 were lung carcinosarcoma (0.35%). Pneumonectomy was done in 6 patients,lobectomy in 8, thoracotomy in 1. Pathologically,squamous carcinoma with fibrosarcoma in 1,adenocarcinoma with fibrosarcoma in 7, adenocarcinoma with chondrosarcoma in 1, and small-cell carcinoma with chondrosarcoma in 1. There was no operation death.Upon follow up,, the 1-, 3-, 5-, and 7-year survival rates were 66.7%, 53.3./., 42.9% and 2/7, respectively. The longest survival was 97 months. The histologica origin,the relationship between pathological findings and clinical features and the diagnosis, treatment and prognosis are discussed.
