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Tang YY, Zhu GQ, Zheng ZJ, Yao LH, Wan ZX, Liang XH, Tang YL. Carcinosarcoma of the deep lobe of the parotid gland in the parapharyngeal region: A case report. World J Clin Cases 2023; 11:7663-7672. [DOI: 10.12998/wjcc.v11.i31.7663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
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.
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Affiliation(s)
- Yue-Yang Tang
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Gui-Quan Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zhi-Jian Zheng
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Li-Hong Yao
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zi-Xin Wan
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin-Hua Liang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ya-Ling Tang
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
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Shaver TB, Youner E, Goodman JF, Samankan S. Minor Salivary Gland Carcinosarcoma of the Floor of the Mouth. Cureus 2023; 15:e37206. [PMID: 37159765 PMCID: PMC10163846 DOI: 10.7759/cureus.37206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Carcinosarcoma is an uncommon tumor consisting of malignant epithelial and mesenchymal elements. Salivary gland carcinosarcoma is aggressive in nature, and given its biphasic histologic appearance, it has the potential to be mistaken for a less concerning entity. Intraoral minor salivary gland carcinosarcoma is exceedingly rare with the palate being the site most frequently involved. Only two cases of carcinosarcoma arising from the floor of the mouth (FOM) have been reported. We present a case of a non-healing FOM ulcer that was identified as a minor salivary gland carcinosarcoma on surgical pathology along with the steps and importance of accurate diagnosis.
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Gupta A, Koochakzadeh S, Neskey DM, Nguyen SA, Lentsch EJ. Salivary Carcinosarcoma: An Extremely Rare and Highly Aggressive Malignancy. Laryngoscope 2019; 130:E335-E339. [DOI: 10.1002/lary.28183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/10/2019] [Accepted: 06/24/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Avigeet Gupta
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - Sina Koochakzadeh
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - David M. Neskey
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - Shaun A. Nguyen
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - Eric J. Lentsch
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
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Woo CG, Son SM. Carcinosarcoma of the parotid gland with abdominal metastasis: a case report and review of literature. World J Surg Oncol 2018; 16:103. [PMID: 29859537 PMCID: PMC5985058 DOI: 10.1186/s12957-018-1406-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/28/2018] [Indexed: 11/24/2022] Open
Abstract
Background Carcinosarcoma of the salivary gland is a rare aggressive malignant tumor, composed of a mixture of carcinomatous and sarcomatous components. The most common metastatic sites include the lungs, bones, and central nervous system. Case presentation This report describes a rare case of carcinosarcoma of the parotid gland with an osteosarcoma as sarcomatous component in a 72-year-old man who had a history of low anterior resection for rectal cancer. Six months after parotidectomy, he presented abdominal pain as a symptom of abdominal metastasis by the sarcomatous component. At that time, the possibility of abdominal metastasis was overlooked because of the history of abdominal surgery. After several days of conservative treatment, emergency laparotomy was done. However, he died of acute respiratory distress syndrome. Conclusions Awareness of the possibility of abdominal metastasis by salivary carcinosarcoma may help in managing patients with a history of abdominal surgery.
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Affiliation(s)
- Chang Gok Woo
- Department of Pathology, Chungbuk National University Hosipital, 776, 1Sunhwan-ro, Seowon-gu, Cheongju, 28644, South Korea
| | - Seung-Myoung Son
- Department of Pathology, Chungbuk National University Hosipital, 776, 1Sunhwan-ro, Seowon-gu, Cheongju, 28644, South Korea.
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Endo Y, Ohashi R, Inai S, Yokoshima K, Nakamizo M, Shimizu A, Okubo K, Naito Z. Carcinosarcoma ex Pleomorphic Adenoma of the Submandibular Gland in a 64-Year-Old Man: A Case Report. J NIPPON MED SCH 2018. [DOI: 10.1272/jnms.2018_85-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yoko Endo
- Department of Analytic Human Pathology, Nippon Medical School
| | - Ryuji Ohashi
- Department of Diagnostic Pathology, Nippon Medical School Hospital
| | - Shunta Inai
- Department of Otolaryngology, Head & Neck Surgery, Nippon Medical School
| | - Kazuhiko Yokoshima
- Department of Otolaryngology, Head & Neck Surgery, Nippon Medical School
| | - Munenaga Nakamizo
- Department of Otolaryngology, Head & Neck Surgery, Nippon Medical School
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School
- Department of Diagnostic Pathology, Nippon Medical School Hospital
| | - Kimihiro Okubo
- Department of Otolaryngology, Head & Neck Surgery, Nippon Medical School
| | - Zenya Naito
- Department of Diagnostic Pathology, Nippon Medical School Hospital
- Department of Integrated Diagnostic Pathology, Nippon Medical School
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Jha V, Kolte S, Goyal S, Mandal AK. Osteosarcoma Arising in Carcinosarcoma De Novo Parotid Gland in a Young Man: An Unusual Case with Review of Literature. J Clin Diagn Res 2017; 11:ED08-ED10. [PMID: 28571153 DOI: 10.7860/jcdr/2017/25259.9636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 01/04/2017] [Indexed: 01/17/2023]
Abstract
Carcinosarcoma of the parotid gland, a true malignant mixed tumour is extremely rare. It may occur in a pre-existing pleomorphic adenoma or arise de novo. We report a case of carcinosarcoma de novo harbouring an osteosarcomatous element in a 35-year-old man along with review of the reported cases. Excision was done and histopathologic examination confirmed the diagnosis. Long term follow up has been recommended for these tumours owing to their high propensity of recurrence and metastasis. Our case discusses the importance of histopathology and limitation of preoperative imaging in the diagnosis of such an aggressive neoplasm; emphasizing the fact that possibility of carcinosarcoma should be kept in mind while dealing with salivary gland lesions even at a younger age.
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Affiliation(s)
- Vidya Jha
- Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sachin Kolte
- Associate Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Surbhi Goyal
- Assistant Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ashish Kumar Mandal
- Director Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Hasnaoui J, Anajar S, Tatari M, Abada R, Rouadi S, Roubal M, Mahtar M. Carcinosarcoma of the maxillary sinus: A rare case report. Ann Med Surg (Lond) 2017. [PMID: 28626581 PMCID: PMC5466550 DOI: 10.1016/j.amsu.2017.05.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract, with only 13 cases reported since 1957 in the literature. Presentation of case We report a case of a 55-year-old man with right-sided face pain revealed a mass in the right maxillary sinus and nasal cavity. A large incisional biopsy from the nasal cavity concluded the diagnosis of carcinosarcoma. The patient was treated with chemoradiation, but no significant effect was obtained. The patient died 4 months after initial examination. Discussion In our case, the patient consulted late with a large tumor which darkens his prognosis. According to some authors, this histological type of tumors is known by local recurrences and its lethal metastases. Prognosis is related to location, tumor size, the invasion and stage of disease. Wide surgical excision is the treatment of choice. Radiotherapy can be discussed in inoperable cases. Conclusion This is an aggressive tumor, rapidly progressive with a poor prognosis. The management of this rare condition remains undetermined. Carcinosarcoma is a rare biphasic neoplasm and a variant of squamous cell carcinoma. Carcinosarcoma is an aggressive tumor, rapidly progressive with a poor prognosis. Occurrence in nasal cavity is very rare and only few cases have been reported. Management for this disease still remains undetermined.
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Affiliation(s)
- Jawad Hasnaoui
- Corresponding author. 6, Street lahssen Elaarjoun quartier des hopitaux, Casablanca, Morocco.6, Street lahssen Elaarjoun quartier des hopitauxCasablancaMorocco
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Mucoepidermoid Carcinoma Associated with Osteosarcoma in a True Malignant Mixed Tumor of the Submandibular Region. Case Rep Otolaryngol 2015; 2015:694684. [PMID: 26600963 PMCID: PMC4639669 DOI: 10.1155/2015/694684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction. True malignant mixed tumor, also known as carcinosarcoma, is a rare tumor of the salivary gland composed of both malignant epithelial and malignant mesenchymal elements. Frequently carcinosarcoma arises in the background of a preexisting pleomorphic adenoma; however, if no evidence of benign mixed tumor is present, the lesion is known as carcinosarcoma “de novo.” We reported the first case of true malignant mixed tumor of the submandibular gland composed of high grade mucoepidermoid carcinoma associated with osteosarcoma. Case Presentation. A 69-year-old Caucasian male came to our department complaining of the appearance of an asymptomatic left submandibular neoformation progressively increasing in size over 3 months. We opted for surgical treatment. Histological examination confirmed the diagnosis of carcinosarcoma with the coexistence of high grade mucoepidermoid carcinoma and osteosarcoma. Conclusion. To the best of our knowledge, in the true malignant mixed tumor of the submandibular gland, mucoepidermoid carcinoma associated with osteosarcoma has never been previously reported.
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Patel TD, Vázquez A, Plitt MA, Baredes S, Eloy JA. A case-control analysis of survival outcomes in sinonasal carcinosarcoma. Am J Otolaryngol 2015; 36:200-4. [PMID: 25465656 DOI: 10.1016/j.amjoto.2014.10.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/20/2014] [Accepted: 10/25/2014] [Indexed: 12/22/2022]
Abstract
PURPOSE Carcinosarcoma is a rare malignant tumor of mixed epithelial and mesenchymal origin. In the head and neck, carcinosarcoma most commonly affects the salivary glands. Primary sinonasal carcinosarcoma (SN-CS) is exceedingly rare. METHODS We performed a retrospective analysis of 15 cases of SN-CS obtained from the Surveillance, Epidemiology and End Results (SEER) database from 1973 to 2010. Case-matched cohorts of non-sinonasal carcinosarcoma (NS-CS), salivary gland carcinosarcoma (SG-CS) and carcinosarcoma at all other head and neck sites (NonSNSG-CS) were used for comparison. RESULTS Women made up 60.0% of the SN-CS cohort and whites 73.3%. Tumors originated in the nasal cavity in 46.7% of cases, and from the maxillary sinus in 33.3%. In 66.7% of cases, tumors were poorly differentiated (histologic grades III and IV). Surgery with radiotherapy was the primary treatment modality in 46.7% of cases. Five-year disease-specific survival (DSS) was 48.5% for SN-CS compared to 65.5% for the case-matched SG-CS cohort (p = 0.2950), whereas it was 76.9% for the case-matched NonSNSG-CS cohort (p =0.0406). CONCLUSION SN-CS is a rare tumor. Here we present the largest known cohort of SN-CS and report on its demographic, clinicopathologic and survival features. Our results suggest that patients with SN-CS have DSS comparable to the case-matched cohort of SG-CS patients. However, SN-CS patients have significantly poor survival outcomes compared to the case-matched cohort of NonSNSG-CS patients.
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Vélez-Pérez A, Huang RSP, Everett JM, Guo S, Buryanek J, Karni RJ, Brown RE. Carcinosarcoma of the parotid: investigating its biology with morphoproteomics. Int J Surg Pathol 2014; 23:116-21. [PMID: 25515562 DOI: 10.1177/1066896914562278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Carcinosarcoma of the parotid is a rare biphasic malignant neoplasm comprised of both carcinomatous and sarcomatous components representing approximately 0.4% of all malignant salivary gland neoplasms. We report a case of a 55-year-old Caucasian man who presented with a progressively enlarging left facial mass. Histopathological evaluation of the tumoral tissue revealed a high grade, mixed epithelial and mesenchymal malignant tumor, most consistent with a carcinosarcoma of the parotid. Morphoproteomic analysis was performed and revealed expression of secreted protein acidic and rich in cysteine (SPARC); glioma-associated oncogen protein 2 (Gli2); and phosphorylated signal transducer and activator of transcription (p-STAT3 [Tyr705]) in the carcinomatous and malignant mesenchymal components. These aforementioned markers have been linked to the epithelial-mesenchymal transition in which epithelial cells lose their characteristics and phenotypically become mesenchymal cells. This finding allows us to further understand the biology of the 2 cellular components of the carcinosarcoma as having a monoclonal origin.
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Affiliation(s)
| | - Richard S P Huang
- The University of Texas at Houston Health Science Center, Houston, TX, USA
| | - Jamie M Everett
- The University of Texas at Houston Health Science Center, Houston, TX, USA
| | - Shan Guo
- The University of Texas at Houston Health Science Center, Houston, TX, USA
| | - Jamie Buryanek
- The University of Texas at Houston Health Science Center, Houston, TX, USA
| | - Ron J Karni
- The University of Texas at Houston Health Science Center, Houston, TX, USA
| | - Robert E Brown
- The University of Texas at Houston Health Science Center, Houston, TX, USA
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