A Case of Metachronous Development of Esophageal Squamous Cell Carcinoma in the Patient with Esophageal Carcinosarcoma / 대한소화기학회지

Esophageal carcinosarcoma is a rare malignant esophageal neoplasm consisting of both carcinomatous and sarcomatous elements, with an incidence of 0.5%. There have been only a few case reports of carcinosarcoma and squamous cell carcinoma coexisting in the esophagus. However, all of these are cases of synchronous or metachronous development of carcinosarcoma after chemoradiotherapy in patients of esophageal squamous cell carcinoma. A 53-year-old man underwent esophagogastroduodenoscopy because of chest pain for several months. Endoscopic examination revealed a huge pedunculated esophageal polypoid mass. Endoscopic submucosal dissection (ESD) was performed and histopathologic examination confirmed spindle cell carcinoma (carcinosarcoma). He refused additional esophagectomy. After 21 months, third follow-up endoscopy showed poorly-demarcated flat, faint discolored lesions at different location from the previous ESD site and endoscopic biopsies confirmed squamous cell carcinoma. To the best of our knowledge, this is the first case of metachronous development of esophageal squamous cell carcinoma in a patient with esophageal carcinosarcoma.

Carcinossarcoma uterino: relato de um caso com invasão da bexiga, mimetizando mullerianose com transformação maligna / Carcinosarcoma of the uterus: report of a case with invasion of the urinary bladder, resembling mullerianosis with malignant transformation

Introdução: Os carcinossarcomas uterinos são neoplasias infrequentes, correspondendo a apenas 3-9 por cento de todas as neoplasias ginecológicas, representam 48 por cento de todos os sarcomas, e possuem incidência de 8,2 por 1 milhão mulheres/ano. As principais manifestações clínicas são o sangramento vaginal anormal em idade pós-menopausa e dor abdominal. Caracterizam-se morfologicamente por elementos epiteliais e estromais. Podem eventualmente invadir estruturas adjacentes, inclusive a bexiga urinária. Relato do caso: Apresentamos um caso de carcinossarcoma uterino com invasão de bexiga mimetizando mullerianose com transformação maligna. A paciente do sexo feminino de 69 anos apresentava hematuria macroscópica como queixa única. Durante a investigação diagnóstica, após cistoscopia com exame anatomopatológico, foi sugerida a hipótese de mullerianose com transformação benigna. A paciente foientão encaminhada para ressecção cirúrgica da neoplasia. Durante o procedimento cirúrgico, notou-se a existência deuma massa tumoral uterina que invadia a bexiga urinária, e, após análise anatomopatológica, mostrou tratar-se de umcarcinossarcoma uterino com invasão vesical. Conclusão: Manifestações incomuns em doenças com grande potencialde malignidade, além de retardar o processo diagnóstico, interferem diretamente no prognóstico do paciente.

Carcinosarcoma / Sarcomatoid carcinoma

El carcinosarcoma es un tumor poco frecuente, bifásico, que ha sido comunicado en diferentes sitios del organismo. Está compuesto por un componente maligno epitelial íntimamente asociado con un componente epitelial sarcomatoide que puede ser homólogo y heterólogo. Existen carcinosarcomas cutáneos y extracutáneos. Los carcinosarcomas extracutáneos muestran un pronóstico pobre. Presentamos un paciente de 75 años, fototipo II, que consulta por presentar un tumor exofítico angiomatoide sangrante de 8 mm, de aspecto botriomicoide, de 2 meses de evolución en piel frontal derecha. Se confirma con biopsia y técnicas de inmunohistoquímica la existencia de 2 morfologías celulares típicas del carcinosarcoma. El tumor fue extirpado con un centímetro de margen de seguridad. El paciente, al año de su intervención, está libre de recurrencias y metástasis. El componente sarcomatoso del tumor es comprendido como una transformación metaplásica del componente carcinomatoso. Estos tumores son potencialmente agresivos.

Carcinosarcoma is an uncommon biphasic neoplasm that has been reported in diverseanatomical sites. This tumor is composed of two malignant epithelial components: onetypical and the other atypical, this one resembling mesenchymal tissue. Both are intimatelyassociated .The latter may be homologous or heterologous. When these tumors are locatedat extracutaneous sites, they are characteristically aggressive.We report a 75-year-old man who developed a solitary reddish bleeding nodule that quicklygrew in a two-months period. It resembled a pyogenic granuloma and was located on hisright frontal skin. Clinical, histologycal and immunohistochemical features were evaluated.The tumor was completely excised with a one-centimeter safety margin, and after a lapse ofone year he is free of local relapses or metastases.The sarcomatous component of the tumor is considered to be a metaplastic transformation ofthe carcinomatous component. These tumors are potentially aggressive if partially removed,thus complete excision is mandatory.

Tumores mesenquimáticos del endometrio / Endometrial mesenchymal tumors. Study of 4 cases

Los tumores mesenquimáticos de la mucosa uterina son un grupo raro, heterogéneo y generalmente agresivo de neoplasias que conduce frecuentemente a una diseminación y muerte temprana. Constituyen menos del 3% de todos los tumores malignos del Tracto Genital Femenino y el 2-7% de las neoplasias malignas uterinas. Presentamos 4 casos de tumores mesenquimáticos diagnosticados en un período de 5 años en el Servicio de Anatomía Patológica del Hospital General de Agudos Carlos G. Durand, analizando su incidencia y haciendo una breve revisión de las características histopatológicas de los mismos

Mesenchymal tumors of the uterine lining are a rare and heterogeneous group of neoplasms, with an agressive behavior leading to an early dissemination and death. They represent less than 3% of all malignant tumors of the Female Genital Tract and 2-7% of uterine malignancies. We report 4 mesenchymal tumors diagnosed throughout a 5 years period at the Department of Pathology Hospital General Carlos G. Durand, analyzing their incidence and making a review of the histopathologic features

Mammary carcinosarcoma in cat: a case report / Carcinossarcoma mamário em gata: relato de Caso

A case of mammary carcinosarcoma is reported in a 13-year-old, mixed breed female cat, which was not spayed and had not received contraceptives. The patient presented extensive and coalescent nodules in all mammary glands. Based on the histological and immunohistochemical findings, the diagnosis of mammary carcinosarcoma was confirmed.

Descreve-se um caso de carcinossarcoma mamário em uma gata, sem raça definida, de 13 anos de idade. A gata não era castrada e não recebeu anticoncepcionais. A paciente apresentou extensivos e coalescentes nódulos em todas as glândulas mamárias. Com base nos achados histológicos e imunoistoquímicos, firmou-se o diagnóstico de carcinossarcoma da glândula mamária.

Carcinosarcoma of the uterus in a woman with Down syndrome

There are only a few reports of uterine cancers in women with Down syndrome, whose tumor profile is marked by a reduced risk for solid neoplasms. There are no reports of a uterine carcinosarcoma arising in a woman with Down syndrome. In our case, a delayed diagnosis of uterine carcinosarcoma was confirmed on a 38-year-old, nulliparous, single, obese women with Down syndrome, who presented with irregular vaginal bleeding. Although uterine cancers are underrepresented in women with Down syndrome, uterine malignancy should be considered in the differential diagnosis of abnormal vaginal bleeding. A timely and complete gynecological examination will preclude a delay in diagnosis

A Case of Carcinosarcoma in the Liver / 대한소화기학회지

Primary hepatic carcinosarcoma which has comprised of a mixture of both carcinomatous and sarcomatous elements is very rare. This tumor has been variously called as carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, or undifferentiated carcinoma. Only less than 20 cases of carcinosarcoma of the liver have been reported sporadically up to now worldwide. Herein, we present a case of carcinosarcoma of the liver along with a review of the literatures.

A Case of Carcinosarcoma in a Patient with Corrosive Esophagitis / 대한소화기학회지

Carcinosarcoma of the esophagus is a rare malignancy accounting for approximately 1-2% of all esophageal neoplasms. It presents as a bulky intraluminal polypoid lesion mainly in the mid to lower esophagus, which harbors both carcinomatous and sarcomatous components histologically. It often presents relatively early because of its rapid intraluminal growth. We report the case of a 69-year-old man who had suffered from dysphagia for 1 month. He was previously admitted to the hospital due to corrosive esophagitis caused by ingestion of acetic acid. Endoscopy and radiological studies revealed a bulky polypoid mass with superficial ulcerations and mucosal friability, measuring 10 cm in length approximately, in the mid-esophagus. Subtotal esophagectomy with esophagogastrostomy was done. Microscopically it was composed of sarcomatous component intermingled with squamous cell carcinoma. Immunohistochemical stains reveal cytokeratin, 34betaE12, and p63 positivity in the nests of carcinoma, and desmin and vimentin positivity in the spindle cells of sarcomatous stoma.

Carcinosarcoma of urinary bladder mimicking vesical calculus: a case report.

We report a 50 year old male who presented with a short history of gross hematuria. An ultrasonogram detected a mass arising from the right lateral wall of the urinary bladder. Computed tomography of the abdomen revealed that the mass was a calcified lesion mimicking a bladder stone. Cystoscopy confirmed the presence of the calcified lesion and biopsy revealed a rare biphasic tumor of the urinary bladder comprising of osteosarcoma and a papillary urothelial neoplasm of low malignant potential. The rarity of this tumor and its associated exuberant calcification make this case an interesting one.

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.

Carcinossarcoma de mama / Carcinosarcoma of the breast: case report

O carcinossarcoma constitui uma forma rara de tumor de mama, correspondendo a cerca de 0,2 por cento dos carcinomas de mama. Descreve-se um caso dessa variante neoplástica em uma mulher de 45 anos, atendida do Serviço de Ginecologia e Mama do Hospital Erasto Gaertner. Discutem-se também aspectos histológicos, bem como opçöes terapêuticas e fatores prognósticos dessa rara neoplasia

Carcinosarcoma renal: informe de un caso con estudios de inmunohistoquímica y ultraestructura / Renal carcinoma: report of a case with immunohystochemical and ultrastructural studies

Los carcinosarcomas renales son tumores bifásicos raros (1.5 por ciento) compuestos por áreas epitelioides y fusocelulares sarcomatosas. El diagnóstico diferencial incluye lesiones primarias y metastásicas en el riñón. En este artículo se informan los hallazgos histopatológicos de inmunohistoquímica y ultraestructura, así como los criterios de diagnóstico descritos en la bibliografía

Carcinosarcoma de localización gloso-epiglótica / Carcinosarcoma of localization epiglottis

En el presente trabajo se hace la presentación de un caso de carcinosarcoma localizado en el surco glosoepiglótico, único caso de la literatura nacional y el cuarto de la literatura mundial. Se presenta el caso con las manifestaciones clínicas referidas y el diagnóstico histopatológico efectuado. El tratamiento realizado fue la resección quirúrgica seguida de cobaltoterapia. El paciente evolucionó bien y está vivo y sin enfermedad 1 año y medio después

Sarcoma de kaposi clásico: metastasis pulmonar en relación a un caso inmunocompetente / Classical kaposis sarcoma: lung metastasis in relation a case an inmunocompetent

El Sarcoma de Kaposis define una lesión reticuloendotelial angiógena que se presenta como lesión marrón púrpura principalmente en extremidades inferiores por debajo de las rodillas o en región perubucal, cuya forma de presentación clásica epidemiológicamente afecta a edades avanzadas, a deferencia de los observados en pacientes con algún grado de inmunocompromiso. Desde el punto de vista epidemiológico se conocen cuatro tipos de Sarcoma de Kaposi, a saber: Clásico, Africano Endénico, Epidémico relacionado al SIDA y al asociado a Terapia Inmunosupresora. Es un tumor que predomina en el sexo masculino con una relación 10:1, que se ha documentado principalmente al Sur y al Este de Europa y Africa. Se han propuesto etiologías vasculares e infecciosas, siendo esta última la más aceptada, involucrando al Herpes virus o al Citomegalovirus. El compromiso pulmonar por Sarcoma de Kaposi es excepcional. Se han informado 6 casos, 5 de ellos con algún grado de inmunocompromiso, bien sea por patología relacionada al SIDA o por inmunosupresión post-quimioterapia de transplante renal. Hemos podido documentar un caso de compromiso pulmonar de Sarcoma de Kaposi en pacientes inmunocompetente, por lo que el presente caso en cuestión sería el segundo caso reportado bajo tales condiciones

Carcinosarcoma de la mama: reporte de un caso / Carcinosarcoma of the breast: report of a case

Se presenta el reporte de un caso de carcinosarcoma de la mama como entidad clinicopatológica poco frecuente dentro de la patología maligna de la mama. Igualmente se hace una revisión bibliográfica

Carcinossarcoma de esôfago: importância diagnóstica da polipectomia endoscópica parcial / Carcinosarcoma of the esophageal: diagnostic importance of partial endoscopic polypectomy

Säo apresentadas as manifestaçöes clínicas e endoscópicas de um caso de carcinossarcoma de esôfago. O esofagograma e a endoscopia revelaram massa polipóide no esôfago médio. O tumor era grande, pediculado, coberto por mucosa lisa, com algumas erosöes. Histopatologicamente, o tumor era composto por uma mistura de invasäo de células queratinizadas e faixas de células arredondadas, lembrando fibrossarcoma. O tumor foi retirado cirurgicamente e näo foi encontrada infiltraçäo de submucosa. Näo foram detectadas metástases à distância ou recidiva local durante 12 meses de seguimento. O diagnóstico inicial foi feito através da realizaçäo de polipectomia endoscópica parcial. Os autores concluem que a polipectomia parcial pode ser valiosa no diagnóstico pré-operatório de massas polipóides e esôfago

Tumor mülleriano misto maligno (carcinossarcoma) / Malignant mixed mullerian tumor (carcinosarcoma)

Os autores apresentam um caso de tumor mülleriano misto maligno do útero, diagnosticado em paciente diabética, com 66 anos de idade, e que apresentou sangramento uterino pós-menopausa. Trata-se de tumor maligno raro, que incide principalmente em mulheres após a menopausa. Os aspectos clínicos, diagnóstico, tratamento e prognóstico säo descritos a seguir.