Pulmonary carcinosarcoma: a case report

Pulmonary carcinosarcoma, belonging to sarcomatoid carcinomas, is a quite rare tumor that contains both malignant epithelial and mesenchymal elements. This tumor has different phenotypic characteristics and clinical course compared to non-small cell lung tumors. A case diagnosed as carcinosarcoma is presented and its clinical and pathological features and the differential diagnosis are discussed. The case was a 74-year-old male admitted with shortness of breath and cough. The chest x-ray showed a left lung mass and a bronchoscopic examination was performed. Histopathological examination of the bronchoscopic biopsy showed necrosis and a malignant tumor consisting of diffuse infiltrative anaplastic cells. Surgery was performed and the case was diagnosed as carcinosarcoma in the resection material. Pulmonary carcinosarcoma is a rare lung tumor. Determination of tumoral cells and performing advanced investigations in resection material seem to be relatively easier than in small biopsies. However, this type of tumor can be encountered in small biopsy materials as in the presented case and should be kept in mind in relation to the differential diagnosis as small tissues can have only one, particularly mesenchymal, tumoral component.     

Sarcomatoid carcinoma (carcinosarcoma) of the esophagus with extensive areas of osseous differentiation: a case report

A 46 year old male presented with progressively increasing dysphagia and weight loss. Esophagoscopy showed a large polypoidal growth involving the middle segment of esophagus. Histologically bulk of the tumour had a sarcoma-like appearance composed of spindly pleomorphic cells along with extensive areas of bone formation. The epithelial element was represented by a small area of squamous cell carcinoma. One of the draining lymph nodes also showed small islands of squamous cell carcinoma. A diagnosis of sarcomatoid carcinoma was made. Sarcomatoid carcinoma of the esophagus, also termed carcinosarcoma, pseudosarcoma, and spindle cell carcinoma is an unusual malignant tumour of the esophagus. The proportion of carcinomatous and sarcomatous component may vary from case to case. Rarely, the sarcomatous component may exhibit osseous differentiation as in our case.     

原发性肝癌肉瘤一例

患者男,37岁.因摔伤后出现上腹部剧烈疼痛于2009年10月10日入院.腹部CT提示:肝左外叶及上腹部临近肝左叶可见2个低密度影,增强时可见局灶性强化(图1).B超提示左肝占位.实验室检查:丙型肝炎病毒阳性,乙肝丙型肝炎病毒、甲胎蛋白(AFP)阴性.体检:上腹部靠近剑突可触及一大小约10 cm×8 cm肿块,压痛明显.     

Mucoepidermoid carcinoma of the esophagus: a case report

The eighth reported case of mucoepidermoid carcinoma of the esophagus is described by light microscopic and ultrastructural examination. The reason of such a paucity of reports, the probable origin, and the natural history of this neoplasm are examined through our observations and reference to the literature.     

Post-irradiation carcinosarcoma of uterus--a case report

The carcinosarcoma (malignant mixed mullerian tumour) of uterus is an aggressive neoplasm composing of malignant glands in the malignant stroma showing biphasic appearance. A 55 year old woman presented with discharge per vaginum of one month duration. Earlier she was given radiotherapy for squamous cell carcinoma of vulva, six years back. Abdominal examination was insignificant. USG suggested presence of post-radiation effect with uterine mass. Panhysterectomy was done and on histopathology, the diagnosis of carcinosarcoma (heterologous variant) was made. The case is being reported and discussed.     

Metaplastic carcinoma of the breast (carcinosarcoma variant): a case report

A case of a female patient aged 60 yrs, with metaplastic carcinoma of the breast which is a rare neoplasm is presented. Although it is a tumor of the ductal type, the predominant component of the neoplasm has an appearance other than glandular pattern and more in keeping with other cell types. Metaplastic carcinoma runs a very aggressive course and bears an unfavourable prognosis.     

食管原发性恶性黑色素瘤一例

患者女,64岁.因心窝部隐闷不适3个月,于2008年5月19日就诊于本院消化内科.患者既往无肿瘤病史,仔细检查体表皮肤、黏膜未见肿瘤生长,予以内窥镜检查.内窥镜下见食管上中段黏膜光滑,下段距门齿32～40 cm食管黏膜见散在蓝色斑点,靠贲门齿状线处黏膜颜色加深呈蓝黑色,贲门右侧壁黏膜小片状粗糙隆起,略呈结节状,活检6块,质地有弹性.     

Immunohistochemical analysis of carcinomatous and sarcomatous components in the uterine carcinosarcoma: a case report

Uterine carcinosarcoma (malignant mixed Mullerian tumor) is an uncommon female genital tract neoplasm characterized by an admixture of epithelial and stromal malignant cells. We report a case of 50-year-old peri-menopausal woman diagnosed to have early-stage (IB due to FIGO) uterine carcinosarcoma of the homologous type with superficial (3mm) myo-invasion. The patient showed no clinical symptoms of the disease and had no family history of female genital tract malignancies. Positive immunostaining for steroid receptors (estrogen-alpha and progesterone receptors), cytokeratin, and EGFR was detected only in the carcinomatous area, whereas beta-catenin, BCL-2, COX-2, p16(INK4a), PTEN, RB-1, and vimentin were immunoreactive in both components. Androgen receptor, CD10, desmin, HER-2/neu, and P53 were found to be negative either in the carcinomatous or in the sarcomatous area. Tumor proliferative activity was higher in the carcinomatous (25%) than in the sarcomatous (2%) component. Based on these findings, immunohistochemical evaluation of multiple receptor status in the carcinomatous and sarcomatous areas of carcinosarcoma may provide a clue to the pathogenesis and hormonal receptor status of this uncommon uterine malignancy.     

Diagnosis of recurrent uterine carcinosarcoma by fine-needle aspiration cytology: report of a case

Uterine carcinosarcomas are uncommon, aggressive neoplasms usually afflicting postmenopausal women. Histologically, they are characterized by the presence of both malignant epithelial and stromal cells. The latter may be either homologous or heterologous in nature. The cytologic diagnosis of carcinosarcoma via fine-needle aspiration (FNA) was previously described for primary tumors arising in the parotid gland, breast, lung, and ovary. Although the diagnosis of uterine carcinosarcoma via cervicovaginal, endometrial, and peritoneal fluid cytology has been described, the FNA cytology diagnosis of recurrent uterine carcinosarcoma has only been rarely described. We present a case of recurrent uterine carcinosarcoma in a 59-yr-old woman, diagnosed by ultrasound-guided FNA cytology. Cytologic smears showed a biphasic neoplasm consisting of both malignant columnar epithelial and spindle cells, in a background of tumor diathesis. This case illustrates the diagnostic utility of aspiration cytology in the investigation of recurrent carcinosarcoma in clinically suspicious lesions arising postsurgery.     

True malignant mixed tumor (carcinosarcoma) of parotid gland : a case report

The malignant mixed tumor (carcinosarcoma) of the salivary gland is an extremely rare tumor. By definition, it is composed of both malignant epithelial and malignant mesenchymal components. We report a case of carcinosarcoma in the parotid gland of a 59 year old man, that arose "de novo" and contained ductal adenocarcinoma as the epithelial component and osteosarcoma and chondrosarcoma as mesenchymal components. The etiologic and histologic features are presented and in addition, the literature is reviewed.     

Villo-glandular adenoma or polypoid dysplasia of esophagus: a case report

Gastrointestinal adenomas are neoplasms of glandular epithelium containing dysplasia of varying degrees. They are rare in esophagus. A case of villous tumor of the esophagus in a 71-year-old man is described. Histologically, this polypoid, villous lesion was developed on Barrett's esophagus and contained dysplastic epithelium and small adenocarcinomatous foci. This case illustrates that esophagus adenoma may be a premalignant lesion like other adenomas of the gastrointestinal tract. The term of polypoid dysplasia has therefore been recommended. This lesion, usually developed in gastric heterotopy or Barrett's esophagus, is often associated with high-grade dysplasia or carcinoma.     

Primary carcinosarcoma of the spleen: case report of a rare tumor and review of the literature

Carcinosarcoma of extragenital organs is rare. In this article, a case of primary carcinosarcoma of the spleen, which presented as painful splenomegaly is reported. To the best of our knowledge, this is the second reported case of primary splenic carcinosarcoma in English literature. The pathogenesis of these tumors is incompletely understood. No specific treatment guidelines exist for these aggressive tumors, surgery being the mainstay of treatment. The prognosis remains poor regardless of the adjuvant therapy used.