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Insights into Clinical Features and Outcomes of Adrenal Cortical Carcinosarcoma. Diagnostics (Basel) 2022; 12:diagnostics12102419. [PMID: 36292108 PMCID: PMC9600293 DOI: 10.3390/diagnostics12102419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/17/2022] Open
Abstract
Adrenal cortical carcinosarcomas are a rare and typically aggressive malignancy with few reported cases in medical literature. We present a case of a 78-year-old female who presented with complaints of fatigue and right shoulder pain. Imaging of the abdomen with computed tomography visualized a large mass in the right upper quadrant. The mass was radiologically described as a 22 × 17 × 13 cm heterogeneous mass with its epicenter in the area of the right adrenal gland, with medial and peripheral effacement of all structures in the right upper quadrant. Non-contrasted images demonstrated anterior mid-portion calcifications. The mass parasitized its blood supply from several surrounding structures, including the liver and right psoas muscle, and extensively invaded the psoas muscle. Resection of the mass was performed with pathology, which revealed a high mitotic index and nuclear atypia with two morphologically and immunophenotypically distinct components. One of these components stained positively for calretinin and inhibin, which is indicative of adrenal cortical carcinoma; the other exhibited strong expression of vimentin and desmin, which was concordant with sarcomatous change and confirmed the diagnosis of adrenal cortical carcinosarcoma. This unique histology with both carcinomatous and sarcomatous components presents a diagnostic challenge for clinicians. As such, adrenal carcinosarcomas should be kept on the differential when evaluating retroperitoneal masses. Additionally, this study includes a review of 34 previously reported cases of adrenal cortical carcinosarcomas along with a discussion about the future exploration of this pathology.
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Vizgan N, Jokar TO, Enayati L, Salyana M, Gotlieb VK. Presentation and treatment of aggressive,
Triple‐Negative
carcinosarcoma of the breast. Clin Case Rep 2022; 10:e6020. [PMID: 35865780 PMCID: PMC9291258 DOI: 10.1002/ccr3.6020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
An extremely rare form of breast cancer, breast carcinosarcoma accounts for less than a percent of all breast malignancies and is highly aggressive. Composed of both cancerous epithelial and mesenchymal cell types, breast carcinosarcoma is associated with a poor prognosis compared to more common breast cancers, and typically lack the receptors typical of other breast carcinomas, which minimize potential targets for treatment. In this case report, we discuss a 56‐year‐old patient affected by carcinosarcoma of the breast at a T2N1 stage, and the decision‐making process that factored into her treatment plan.
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Affiliation(s)
- Niels Vizgan
- Department of Chemistry Wesleyan University Middletown Connecticut USA
| | | | - Ladan Enayati
- Department of Haematology/Oncology Brookdale University Hospital and Medical Center Brooklyn New York USA
| | - Muhammad Salyana
- Department of Haematology/Oncology Brookdale University Hospital and Medical Center Brooklyn New York USA
| | - Vladimir K. Gotlieb
- Department of Haematology/Oncology Brookdale University Hospital and Medical Center Brooklyn New York USA
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Primary Carcinosarcoma of the Spleen: A Rare Case Report of Incidental Finding after Splenic Trauma. Case Rep Surg 2020; 2020:8816931. [PMID: 33101753 PMCID: PMC7569425 DOI: 10.1155/2020/8816931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/18/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
Primary carcinosarcoma of the spleen is a rare, aggressive splenic malignancy. To date, seven cases have been reported in the literature. We report a first case of primary carcinosarcoma of the spleen in France. A 75-year-old woman with a medical history of hysterectomy for uterine adenocarcinoma presented with left hypochondrium pain following blunt abdominal trauma. A splenic mass was noted on computed tomography (CT) scan. A splenectomy was performed by laparotomy. Histology revealed a malignant mixed Mullerian tumor. The PET scan allowed us to confirm that it was a primary lesion of the spleen. She is currently undergoing adjuvant chemotherapy despite the tumor progression. The interest of this case lies in the rarity of primary carcinosarcomas of the spleen and the circumstances of its diagnosis.
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Luong TMH, Akazawa Y, Mussazhanova Z, Matsuda K, Ueki N, Miura S, Hara T, Yokoyama H, Nakashima M. Cutaneous pilomatrical carcinosarcoma: a case report with molecular analysis and literature review. Diagn Pathol 2020; 15:7. [PMID: 32005258 PMCID: PMC6993389 DOI: 10.1186/s13000-020-0925-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/15/2020] [Indexed: 01/09/2023] Open
Abstract
Background Cutaneous pilomatrical carcinosarcoma (CS) is a very rare biphasic tumor composed of admixed epithelial and mesenchymal malignant cells, with limited information on its pathogenesis. We report a case of pilomatrical CS of the scalp with comparative immunohistochemical and molecular analysis together with a review of the literature. Case presentation A 74-year-old woman presented with a rapidly growing long-standing tumor of the scalp. The tumor was surgically resected. Histologically, the tumor was 25 mm in diameter, and was composed of carcinoma showing a clear pilomatrical differentiation and sarcoma with pleomorphic spindle cells and giant cells. Both epithelial and mesenchymal components shared focal cytoplasmic and/or nuclear accumulation of β-catenin based on immunohistochemical analysis, although a mutation of exon 3 of the CTNNB1 gene was not detected. Fluorescence in situ hybridization analysis revealed gains of chromosomes 9p21, 3, and 7 in both the epithelial and sarcomatous components. Conclusions The current case demonstrated characteristic findings of pilomatricoma and further evidence of partial clonality between the carcinomatous and sarcomatous component, suggesting the possibility of malignant transformation of pilomatricoma. Rapid growth of a pilomatrical tumor should warrant the development of a malignant tumor, including CS.
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Affiliation(s)
- Thi My Hanh Luong
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Yuko Akazawa
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan.
| | - Zhanna Mussazhanova
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Katsuya Matsuda
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Nozomi Ueki
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Shiro Miura
- Department of Pathology, National Hospital Organization Nagasaki Medical Center, Omura, 856-8562, Nagasaki, Japan
| | - Toshihide Hara
- Department of Dermatology, Isahaya General Hospital, Isahaya, Japan
| | - Hiroko Yokoyama
- Department of Dermatology, Isahaya General Hospital, Isahaya, Japan
| | - Masahiro Nakashima
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
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Kwak HB, Park J, Kim HU, Nam KH, Yun SK. Cutaneous Carcinosarcoma: a Clinicopathologic and Immunohistochemical Analysis of 11 Korean Cases. J Korean Med Sci 2019; 34:e5. [PMID: 30618513 PMCID: PMC6318441 DOI: 10.3346/jkms.2019.34.e5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS The mean patient age at diagnosis was 71.5 years (range, 43-96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.
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Affiliation(s)
- Hyun-Bin Kwak
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Jin Park
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Han-Uk Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Kyung-Hwa Nam
- Department of Dermatology, Presbyterian Medical Center, Jeonju, Korea
| | - Seok-Kweon Yun
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Abstract
Mesenchymal Stem Cells (MSCs) are a heterogeneous population of fibroblast-like cells which maintain self-renewability and pluripotency to differentiate into mesodermal cell lineages. The use of MSCs in clinical settings began with high enthusiasm and the number of MSC-based clinical trials has been rising ever since. However; the very unique characteristics of MSCs that made them suitable to for therapeutic use, might give rise to unwanted outcomes, including tumor formation and progression. In this paper, we present a model of carcinogenesis initiated by MSCs, which chains together the tissue organization field theory, the stem cell theory, and the inflammation-cancer chain. We believe that some tissue resident stem cells could be leaked cells from bone marrow MSC pool to various injured tissue, which consequently transform and integrate in the host tissue. If the injury persists or chronic inflammation develops, as a consequence of recurring exposure to growth factors, cytokines, etc. the newly formed tissue from MSCs, which still has conserved their mesenchymal and stemness features, go through rapid population expansion, and nullify their tumor suppressor genes, and hence give rise to neoplastic cell (carcinomas, sarcomas, and carcino-sarcomas). Considering the probability of this hypothesis being true, the clinical and therapeutic use of MSCs should be with caution, and the recipients' long term follow-up seems to be insightful.
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Still SA, Becerra CR, Clement-Kruzel SE, Cavaness KM. Locally advanced carcinosarcoma of the pancreas. Proc (Bayl Univ Med Cent) 2018; 31:210-212. [PMID: 29706823 DOI: 10.1080/08998280.2018.1444302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 01/01/2018] [Accepted: 01/04/2018] [Indexed: 12/27/2022] Open
Abstract
Carcinosarcoma is a rare subtype of pancreatic neoplasm including both carcinomatous and sarcomatous components. Fewer than 30 cases have been reported to the Surveillance, Epidemiology, and End Results Program database. Given such rarity, definitive treatment guidelines are not well defined. We report a case of pancreatic carcinosarcoma diagnosed in our institution, review tumor clinicopathological characteristics, and describe our medical and surgical management strategy.
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Affiliation(s)
- Sasha A Still
- Department of Surgery, Baylor University Medical Center at Dallas, Dallas, Texas
| | - Carlos R Becerra
- Charles A. Sammons Cancer Center, Baylor University Medical Center at Dallas, Dallas, Texas
| | | | - Keith M Cavaness
- Department of Surgery, Baylor University Medical Center at Dallas, Dallas, Texas.,Charles A. Sammons Cancer Center, Baylor University Medical Center at Dallas, Dallas, Texas
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Clark JJ, Bowen AR, Bowen GM, Hyngstrom JR, Hadley ML, Duffy K, Florell SR, Wada DA. Cutaneous carcinosarcoma: a series of six cases and a review of the literature. J Cutan Pathol 2016; 44:34-44. [DOI: 10.1111/cup.12843] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Joshua J. Clark
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Anneli R. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Glen M. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
| | - John R. Hyngstrom
- Department of Surgery; University of Utah and Huntsman Cancer Institute; Salt Lake City UT USA
| | - Michael L. Hadley
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Keith Duffy
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Scott R. Florell
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - David A. Wada
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
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