RESUMO
INTRODUCTION: Sarcomatoid carcinoma (SC) of the lung is defined by the World Health Organization as poorly differentiated non-small cell carcinoma that contains a component of sarcoma or sarcoma-like elements. It represents an overall continuum of epithelial and mesenchymal differentiation. Five subtypes are recognized: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. The diagnosis is pathological and requires a good sampling of the tumor. PATIENTS AND METHODS: Twenty-eight cases of primary sarcomatoid carcinoma, diagnosed between 1993 and 2010, were reviewed retrospectively, noting the clinicopathological characteristics. RESULTS: The patient population consisted of 25 males and 3 females with mean age of 62.9 years (48-75 years). The symptomatology was dominated by respiratory symptoms. Imaging features showed a pulmonary mass invading pleura or thoracic wall in 5 cases. The diagnosis was made in all cases on histological examination. These 28 tumors were divided as below: into 19 pleomorphic carcinomas, 4 giant cell carcinomas, 1 spindle cell carcinoma and 4 carcinosarcomas. Twenty-seven tumors were treated surgically. Associated treatments were neoadjuvant (3 cases) or adjuvant chemotherapy (1 case) and preoperative radiotherapy (5 cases). Deaths occurred in 7 patients. Twenty-two patients were lost to follow up. CONCLUSION: These tumors are frequently symptomatic, are locally advanced, and have higher rates of recurrence. Its prognosis is worse than that of other non-small cell lung cancer.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoma/patologiaRESUMO
BACKGROUND: Primary tumors of the sternum are rare and account only 0.5% of all primary bone tumors. They are often malignant, osteolytic and aggressive. They often present difficulties in management. AIM: to determine clinical, pathological and therapeutic characteristics for primary malignant tumors of the sternum. PATIENTS AND METHODS: We report a series of six cases of primary malignant tumors of the sternum, collected in our institution between 1993 and 2009. RESULTS: There were 4 men and 2 women with a mean age of 69, 5 years. Parietal swelling was the most frequent symptom. Imaging showed a sternal lytic lesion. Three tumors were treated surgically. Associated treatments were neoadjuvant chemotherapy (1 case) and postoperative radiotherapy (1 case). A medical treatment (radiotherapy alone or chemotherapy) was performed in 3 cases. These tumors were divided as below: 3 plasmacytoma, 1 chondrosarcoma, 1 osteosarcoma and 1 large B cell lymphoma. CONCLUSION: The management of primary malignant tumors of the sternum is multidisciplinary. It depends on the histological type, the possibility of surgical treatment and the distant and local aggressiveness.