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Li P, Zhang L, Liang J, Tuo HF. A sarcomatoid carcinoma in the pancreas tail: A case report with literature review. Asian J Surg 2024; 47:2349-2351. [PMID: 38331612 DOI: 10.1016/j.asjsur.2024.01.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Pengcheng Li
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Liangliang Zhang
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Jiale Liang
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Hong Fang Tuo
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China.
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Chen X, Guo Q, Chen X, Zheng W, Kang Y, Cao D. Clinical and multiparametric MRI features for differentiating uterine carcinosarcoma from endometrioid adenocarcinoma. BMC Med Imaging 2024; 24:48. [PMID: 38373912 PMCID: PMC10877902 DOI: 10.1186/s12880-024-01225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/06/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION The purpose of our study was to differentiate uterine carcinosarcoma (UCS) from endometrioid adenocarcinoma (EAC) by the multiparametric magnetic resonance imaging (MRI) features. METHODS We retrospectively evaluated clinical and MRI findings in 17 patients with UCS and 34 patients with EAC proven by histologically. The following clinical and pathological features were evaluated: post- or pre-menopausal, clinical presentation, invasion depth, FIGO stage, lymphaticmetastasis. The following MRI features were evaluated: tumor dimension, cystic degeneration or necrosis, hemorrhage, signal intensity (SI) on T2-weighted images (T2WI), relative SI of lesion to myometrium on T2WI, T1WI, DWI, ADCmax, ADCmin, ADCmean (RSI-T2, RSI-T1, RSI-DWI, RSI-ADCmax, RSI-ADCmin, RSI-ADCmean), ADCmax, ADCmin, ADCmean, the maximum, minimum and mean relative enhancement (RE) of lesion to myometrium on the arterial and venous phases (REAmax, REAmin, REAmean, REVmax, REVmin, REVmean). Receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were used to evaluate prediction ability. RESULTS The mean age of UCS was higher than EAC. UCS occurred more often in the postmenopausal patients. UCS and EAC did not significantly differ in depth of myometrial invasion, FIGO stage and lymphatic metastasis. The anterior-posterior and transverse dimensions were significantly larger in UCS than EAC. Cystic degeneration or necrosis and hemorrhage were more likely occurred in UCS. The SI of tumor on T2WI was more heterogeneous in UCS. The RSI-T2, ADCmax, ADCmean, RSI-ADCmax and RSI-ADCmean of UCS were significantly higher than EAC. The REAmax, REAmin, REAmean, REVmax, REVmin and REVmean of UCS were all higher than EAC. The AUCs were 0.72, 0.71, 0.86, 0.96, 0.89, 0.84, 0.73, 0.97, 0.88, 0.94, 0.91, 0.69 and 0.80 for the anterior-posterior dimension, transverse dimension, RSI-T2, ADCmax, ADCmean, RSI-ADCmax, RSI-ADCmean, REAmax, REAmin, REAmean, REVmax, REVmin and REVmean, respectively. The AUC was 0.997 of the combined of ADCmax, REAmax and REVmax. Our study showed that ADCmax threshold value of 789.05 (10-3mm2/s) can differentiate UCS from EAC with 100% sensitivity, 76.5% specificity, and 0.76 AUC, REAmax threshold value of 0.45 can differentiate UCS from EAC with 88.2% sensitivity, 100% specificity, and 0.88 AUC. CONCLUSION Multiparametric MRI features may be utilized as a biomarker to distinguish UCS from EAC.
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Affiliation(s)
- Xiaodan Chen
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, 350005, Fujian, P.R. China
| | - Qingyong Guo
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China
| | - Xiaorong Chen
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, 350005, Fujian, P.R. China
| | - Wanjing Zheng
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, 350005, Fujian, P.R. China
| | - Yaqing Kang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, 350005, Fujian, P.R. China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, 350005, Fujian, P.R. China.
- Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, P.R. China.
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, P.R. China.
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da Silveira KG, de Almeida Souto Montenegro L, de Albuquerque DS, do Lago CAP, Laureano Filho JR, de Vasconcellos RJH. Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review. J Oral Pathol Med 2024; 53:20-30. [PMID: 38164057 DOI: 10.1111/jop.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/04/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.
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Rueda DA, Antinucci F, Amante MF, Bas CA. [Primary hepatic sarcomatoid carcinoma, an unusual case]. Medicina (B Aires) 2024; 84:337-341. [PMID: 38683520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Primary hepatic sarcomatoid carcinoma is a very aggressive tumor, representing 0.4-0.7% of all primary hepatic neoplasms. The disease is associated with liver disease due to hepatotropic viruses and is more prevalent in Asians. Histology shows sarcomatous and carcinoma components. It does not have pathognomonic clinical or imaging characteristics and its diagnosis is based on the pathological and immunohistochemistry findings. Surgery could prolong survival in localized stages. We report the case of a 72-year-old Korean patient with a history of chronic liver disease due to B virus, who was diagnosed with primary hepatic sarcomatoid carcinoma with bone and lymph node metastases.
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Affiliation(s)
- Darío A Rueda
- Instituto de Oncología, Hospital Alemán de Buenos Aires, Argentina. E-mail:
| | | | - Marcelo F Amante
- Servicio de Anatomía Patológica, Hospital Alemán de Buenos Aires, Argentina
| | - Carlos A Bas
- Instituto de Oncología, Hospital Alemán de Buenos Aires, Argentina
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5
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Sarda H, Pandey A, Gatuam A, Nellikoppad HS. Asymptomatic giant gastric carcinosarcoma. BMJ Case Rep 2023; 16:e255680. [PMID: 37816582 PMCID: PMC10565129 DOI: 10.1136/bcr-2023-255680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
Carcinosarcoma is an aggressive malignant neoplasm separate from adenocarcinoma with need for a radical early treatment for good response and survival. Less than 75 cases have been reported worldwide. Here, we report a case of an asymptomatic carcinosarcoma of stomach in a lady in her 70's presenting incidentally who underwent distal gastrectomy with Billroth II reconstruction for a large epigastric mass along with a review of literature. Although carcinosarcoma in the stomach is a rare entity, it should be considered as a differential diagnosis in a rapidly growing gastric growth. It requires further descriptions and collections of individual cases.
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Affiliation(s)
- Hitesh Sarda
- Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Anshuman Pandey
- Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Abhishek Gatuam
- Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
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Cao R, Jiang H, Zhang W. Gallbladder carcinosarcoma invading the common bile duct: A case report. Asian J Surg 2023; 46:4637-4638. [PMID: 37244829 DOI: 10.1016/j.asjsur.2023.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023] Open
Affiliation(s)
- RunMin Cao
- Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - HongHe Jiang
- Department of Clinical Medicine, Anhui University of Science and Technology, Huainan City, Anhui Province, China
| | - WeiBin Zhang
- Department of General Surgery, Jinzhou Medical University Postgraduate Training Base (Jinzhou Central Hospital), Jinzhou City, Liaoning Province, China.
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Ogasawara T, Mashiko T, Masuoka Y, Ei S, Takahashi S, Kondo Y, Mori M, Yamamoto S, Koyanagi K, Nakagohri T. True Carcinosarcoma of the Gallbladder: A Case Report and Brief Review of the Literature. Tokai J Exp Clin Med 2022; 47:149-153. [PMID: 36073288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Carcinosarcoma of the gallbladder (CSGB) is very rare, accounting for less than 1% of gallbladder malignancies. Therefore, the biological behavior is not well known. We report the case of a patient with CSGB who showed long-term survival after treatment with surgery and postoperative adjuvant chemotherapy. CASE PRESENTATION A 79-year-old man was referred to our department with suspected gallbladder cancer after undergoing positron emission tomography-computed tomography (PET-CT) scan for preoperative examination of lung cancer, which showed strong accumulation in the gallbladder. Abdominal contrast-enhanced computed tomography (CT) demonstrated a heterogeneous enhanced, 25-mm mass in the anterior wall of the gallbladder fundus. Cholecystectomy and hepatoduodenal mesenteric lymph node sampling revealed a polypoid tumor. Histopathological findings showed a mixture of adenocarcinoma and sarcoma with spindle-shaped cells. Immunohistochemical s taining of the s arcoma s howed negative results for the epithelial markers and positive results for the mesenchymal markers, leading to a diagnosis of true CSGB. We administered S-1 as postoperative adjuvant chemotherapy and was reported to be alive 45 months after surgery without recurrence. CONCLUSION CSGB has a poor prognosis, but if radical resection can be performed, there is a possibility of long-term survival. Further case studies and treatment options are needed to help understand this disease.
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Affiliation(s)
| | - Taro Mashiko
- Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Huang CH, Lee LC, Gao HW, Chen YH, Chien KH. Successful Resection of Retrobulbar Carcinosarcoma without Recurrence: A Case Report. Medicina (B Aires) 2022; 58:medicina58020317. [PMID: 35208640 PMCID: PMC8874590 DOI: 10.3390/medicina58020317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Abstract
Carcinosarcomas are biphasic tumors comprising carcinoma and sarcoma components that occur in many tissues but are rarely found in the orbit. A 70-year-old male presented to the ophthalmic clinic with progressive proptosis, having decreased vision in the left eye for 8 months. On examination, severe exophthalmos and lagophthalmos with limited extraocular movement were noted. Orbital computed tomography scans revealed a large, well-defined, heterogeneously enhanced mass in the left retrobulbar orbital cavity. The tumor was completely resected, and the pathological examination revealed a carcinosarcoma. The prognosis was excellent without local recurrence at 48 months postoperatively. Thus, when considering treatment for effective management of such tumors, tumor resection followed by radiotherapy or chemotherapy is highly recommended.
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Affiliation(s)
- Chun-Hao Huang
- Department of Ophthalmology, Taichung Armed Forces General Hospital, Taichung City 41168, Taiwan;
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (L.-C.L.); (Y.-H.C.)
| | - Lung-Chi Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (L.-C.L.); (Y.-H.C.)
| | - Hong-Wei Gao
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- Department of Pathology, Tungs’ Taichung Metroharbor Hospital No. 699, Section 8, Taiwan Boulevard, Wuqi District, Taichung City 43503, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (L.-C.L.); (Y.-H.C.)
| | - Ke-Hung Chien
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (L.-C.L.); (Y.-H.C.)
- Correspondence: ; Tel.: +886-2-87923311
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9
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Ciccarone F, Biscione A, Moro F, Fischerova D, Savelli L, Munaretto M, Jokubkiene L, Sladkevicius P, Chiappa V, Fruscio R, Franchi D, Epstein E, Timmerman D, Froyman W, Valentin L, Scambia G, Testa AC. Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma. Ultrasound Obstet Gynecol 2022; 59:241-247. [PMID: 34225386 DOI: 10.1002/uog.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of ovarian carcinosarcoma. METHODS This was a retrospective multicenter study. Patients with a histological diagnosis of ovarian carcinosarcoma, who had undergone preoperative ultrasound examination between 2010 and 2019, were identified from the International Ovarian Tumor Analysis (IOTA) database. Additional patients who were examined outside of the IOTA study were identified from the databases of the participating centers. The masses were described using the terms and definitions of the IOTA group. Additionally, two experienced ultrasound examiners reviewed all available images to identify typical ultrasound features using pattern recognition. RESULTS Ninety-one patients with ovarian carcinosarcoma who had undergone ultrasound examination were identified, of whom 24 were examined within the IOTA studies and 67 were examined outside of the IOTA studies. Median age at diagnosis was 66 (range, 33-91) years and 84/91 (92.3%) patients were postmenopausal. Most patients (67/91, 73.6%) were symptomatic, with the most common complaint being pain (51/91, 56.0%). Most tumors (67/91, 73.6%) were International Federation of Gynecology and Obstetrics (FIGO) Stage III or IV. Bilateral lesions were observed on ultrasound in 46/91 (50.5%) patients. Ascites was present in 38/91 (41.8%) patients. The median largest tumor diameter was 100 (range, 18-260) mm. All ovarian carcinosarcomas contained solid components, and most were described as solid (66/91, 72.5%) or multilocular-solid (22/91, 24.2%). The median diameter of the largest solid component was 77.5 (range, 11-238) mm. Moderate or rich vascularization was found in 78/91 (85.7%) cases. Retrospective analysis of ultrasound images and videoclips using pattern recognition in 73 cases revealed that all tumors had irregular margins and inhomogeneous echogenicity of the solid components. Forty-seven of 73 (64.4%) masses appeared as a solid tumor with cystic areas. Cooked appearance of the solid tissue was identified in 28/73 (38.4%) tumors. No pathognomonic ultrasound sign of ovarian carcinosarcoma was found. CONCLUSIONS Ovarian carcinosarcomas are usually diagnosed in postmenopausal women and at an advanced stage. The most common ultrasound appearance is a large solid tumor with irregular margins, inhomogeneous echogenicity of the solid tissue and cystic areas. The second most common pattern is a large multilocular-solid mass with inhomogeneous echogenicity of the solid tissue. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Ciccarone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Biscione
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - D Fischerova
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Savelli
- Gynecologic and Obstetric Unit, Women's and Children's Department, Forlì Hospital, Forlì, Italy
| | - M Munaretto
- Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - L Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - P Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - V Chiappa
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - R Fruscio
- Clinic of Obstetrics and Gynecology, University of Milano-Bicocca, Department of Medicine and Surgery, San Gerardo Hospital, Monza, Italy
| | - D Franchi
- Gynecologic Oncology Unit, Division of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Epstein
- Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | - D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - W Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - L Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Almeida PC, Amaral Ferreira L, Donato P. Uterine carcinosarcoma with extensive extrauterine component. BMJ Case Rep 2021; 14:e247643. [PMID: 34880043 PMCID: PMC8655547 DOI: 10.1136/bcr-2021-247643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Pedro Carvalho Almeida
- Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Luís Amaral Ferreira
- Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Paulo Donato
- Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
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11
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Okoshi Y, Sakata R, Takeo M, Katsuyama E. [Pulmonary Carcinosarcoma of Right Middle Lobe Extending to the Left Main Bronchus]. Kyobu Geka 2021; 74:979-982. [PMID: 34795137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 72-year-old man with a lung tumor admitted to our hospital for surgical treatment. Computed tomography (CT) revealed a mass in the right middle lobe extending to the truncus intermedius and the left main bronchus. The enucleation of the tumor in the left main bronchus was performed with a bronchoscope followed by right middle and lower lobectomy. From the bronchial stump, the residual tumor was observed in the bronchus and was able to be pulled out since there was no invasion of the tumor into the bronchial wall. Pathological diagnosis was pulmonary carcinosarcoma.
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Affiliation(s)
- Yusuke Okoshi
- Department of Thoracic Surgery, Kobe City Hospital Organization Kobe City Medical Center West Hospital, Kobe, Japan
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12
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Suthar RR, Agrawal A, Bal M, Purandare N, Shah S, Puranik A, Rangarajan V. Carcinosarcoma Gallbladder With Osteosarcomatous Differentiation. Clin Nucl Med 2021; 46:e488-e489. [PMID: 33867454 DOI: 10.1097/rlu.0000000000003654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ABSTRACT We herein present a case of carcinosarcoma gallbladder with osteosarcomatous differentiation in a middle-aged woman. This is seen on 18F-FDG PET/CT study as an intensely FDG-avid mass in the gallbladder with foci of calcification due to the presence of osteoid. This is a rare malignancy with poor prognosis.
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Affiliation(s)
- Ritesh R Suthar
- From the Departments of Nuclear Medicine and Molecular Imaging
| | - Archi Agrawal
- From the Departments of Nuclear Medicine and Molecular Imaging
| | - Munita Bal
- Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | | | - Sneha Shah
- From the Departments of Nuclear Medicine and Molecular Imaging
| | - Ameya Puranik
- From the Departments of Nuclear Medicine and Molecular Imaging
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Cheng L, Liu Y, Lou C, Cheng L. A case of pancreatic carcinosarcoma detected on PET/CT. Hell J Nucl Med 2021; 24:262-264. [PMID: 34901965 DOI: 10.1967/s002449912408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/27/2021] [Indexed: 06/14/2023]
Abstract
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm composed of a mixture of sarcomatous and carcinomatous elements. With fewer than forty cases ever reported, the recognition of this rare phenomenon can be difficult. In the present case, a 73-year-old woman with pancreatitis underwent computed tomography which revealed wall-off pancreatic necrosis. Following initial and delayed fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed high uptake of tracer in pancreatic mass, endoscopic biopsy revealed carcinosarcoma. The patient underwent laparoscopic pancreato-caudal resection and was confirmed to have pancreatic carcinosarcoma on microscopic evaluation. The case shows the importance of PET/CT on the early diagnosis in pancreatic mass, and suggests pancreatic carcinosarcoma should be considered as a possible differential diagnosis, which can hasten treatment and improve patient outcomes.
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Affiliation(s)
- Lingxiao Cheng
- Department of Nuclear Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3, East Qingchun Road, Hangzhou 310016, China. ,
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14
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Li C, Tian Y, Chen J, Wen B, He Y. An Unusual Case of Esophageal Carcinosarcoma on 18F-FDG PET/CT. Clin Nucl Med 2021; 46:659-660. [PMID: 33512947 DOI: 10.1097/rlu.0000000000003514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Carcinosarcoma of the esophagus is a rare malignant neoplasm. Here, we report a case of esophageal carcinosarcoma with lymphatic and pulmonary metastases on 18F-FDG PET/CT in a 64-year-old woman.
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Affiliation(s)
- Chongjiao Li
- From the Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
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Rao YF, Cheng DN, Qiu K, Song Y, Zhao Y, Gu D, Ren J. Sinonasal teratocarcinosarcoma: a case report and literature review. J Int Med Res 2020; 48:300060520971488. [PMID: 33342340 PMCID: PMC7754799 DOI: 10.1177/0300060520971488] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/13/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sinonasal teratocarcinosarcoma (SNTCS) is a highly invasive malignant tumor most frequently found in the nasal cavity and paranasal sinuses. As a result, it can be confused with other sinonasal tumors. In addition, SNTCS progresses rapidly and often infiltrates other tissues or organs in the early phase, resulting in poor patient prognosis. The objective of this article was to report the case of a patient with SNTCS and discuss the management strategy. Furthermore, we conducted a literature review for SNTCS and summarized the findings from 107 cases.Case presentation: Here, we report a 47-year-old man diagnosed with SNTCS and treated with radiochemotherapy after an initial operation. After follow-up for 5 years, no tumor recurrence was observed. CONCLUSIONS As SNTCS progresses rapidly, early diagnosis and surgical treatment combined with radiochemotherapy can improve patient survival.
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Affiliation(s)
| | | | - Ke Qiu
- Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
| | - Yao Song
- Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhao
- Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
| | - Deying Gu
- Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
| | - Jianjun Ren
- Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
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16
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Saida T, Mori K, Tanaka YO, Sakai M, Amano T, Kikuchi S, Masuoka S, Yoshida M, Masumoto T, Satoh T, Minami M. Carcinosarcoma of the ovary: MR and clinical findings compared with high-grade serous carcinoma. Jpn J Radiol 2020; 39:357-366. [PMID: 33216290 DOI: 10.1007/s11604-020-01072-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/04/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To clarify imaging and clinical characteristics of ovarian carcinosarcoma (CS) compared with high-grade serous carcinoma (HGSC). METHODS We retrospectively reviewed MR imagings of 12 patients with CS and 30 patients with HGSC and evaluated tumor size, shape, appearance, nature of cystic and solid components, hemorrhage, and necrosis. Age, premenopausal or postmenopausal, histologic subtype, presence of endometriosis, tumor markers, and stage were also evaluated. These parameters were compared using the Mann-Whitney U test and the chi-square test/Fisher's exact test. RESULTS The mean size of CSs was 13.6 cm, and significantly larger than that of HGSCs (mean 9.0 cm, p = 0.022). The stained-glass appearance (67% vs. 23%, p = 0.013), hemorrhage (100% vs. 50%, p = 0.003), necrosis (75.0% vs. 13%, p = 0.000), and endometriosis (33% vs. 7%, p = 0.012) were significantly more common in CSs. The postmenopausal ratio of CSs was 100% and significantly higher than that of HGSCs (70.0%, p = 0.041). Among the tumor makers, only CA-125 was significantly lower in CSs than in HGSCs (mean 715.1 U/ml vs. 1677.1 U/ml, p = 0.009). The stage distribution was similar and was not significantly different. CONCLUSION CSs formed larger masses, and the stained-glass appearance, hemorrhage, and necrosis were more frequently observed in CSs.
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Affiliation(s)
- Tsukasa Saida
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Kensaku Mori
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yumiko Oishi Tanaka
- Department of Diagnostic Imaging, The Cancer Institute Hospital Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Masafumi Sakai
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Taishi Amano
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shunsuke Kikuchi
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Souta Masuoka
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Miki Yoshida
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomohiko Masumoto
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Manabu Minami
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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17
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Zhao S, Su W, Deng L, Chen Y, Zuo C, Shao C, Ren F. Pancreatic sarcomatoid carcinoma: CT, MRI, and 18F-FDG PET/CT features. Clin Radiol 2020; 75:397.e7-397.e14. [PMID: 32044096 DOI: 10.1016/j.crad.2020.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/03/2020] [Indexed: 12/17/2022]
Abstract
AIM To investigate computed tomography (CT), magnetic resonance imaging (MRI), and combined 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography (PET)/CT features of pancreatic sarcomatoid carcinoma (PSC). MATERIALS AND METHODS The hospital database was searched retrospectively for the patients with PSC confirmed at histopathology after surgery. Ten patients who underwent unenhanced and enhanced CT (n=4), unenhanced and enhanced MRI (n=2), 18F-FDG PET/CT (n=2), and both enhanced CT and 18F-FDG PET/CT (n=2) were enrolled. Two patients underwent additional delayed PET/CT. The maximum standardised uptake value (SUVmax) was measured on PET/CT images. RESULTS Eleven lesions were detected in 10 patients. Solid and cystic components (n=6), intratumoural haemorrhage (n=1), nodular calcification (n=2), main pancreatic duct dilatation resulted from lesion obstruction (n=5) or compression (n=3), cholangiectasis (n=5), vascular and peripheral organ invasion (n=5 and 6, respectively), hepatic and lymphatic metastases (n=4 and 2, respectively) were detected. All five lesions in four patients who underwent PET/CT showed intense FDG uptake on PET/CT with SUVmax (16, range 10.9-21.1). Increase of FDG uptake (SUVmax = 18.9, 20.1, and 27.3, respectively) was revealed on the delayed scan of three lesions in two patients. CONCLUSIONS PSCs were more commonly ill-defined solid cystic masses, which caused pancreatic duct obstruction/compression without pancreatic parenchymal atrophy, and these masses on PET/CT showed high FDG uptake on both initial and delayed PET/CT.
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Affiliation(s)
- S Zhao
- Department of Nuclear Medicine, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China
| | - W Su
- Department of Nuclear Medicine, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China
| | - L Deng
- Department of Pathology, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Y Chen
- Department of Pathology, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China
| | - C Zuo
- Department of Nuclear Medicine, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China
| | - C Shao
- Department of Radiology, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China.
| | - F Ren
- Department of Nuclear Medicine, Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China.
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18
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Liu C, Wei S, Wu M, Kong W. Imaging features of ultrasound and contrast-enhanced ultrasound in primary hepatic carcinosarcoma: three cases report. Med Ultrason 2019; 21:487-490. [PMID: 31765459 DOI: 10.11152/mu-2002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Primary hepatic carcinosarcoma (PHCS) is a very rare malignant tumor with a poor prognosis. Previous studies in the English-language literature were case reports, focused on the clinical aspects, pathology and pathogenesis. Much is unknownabout the imaging characteristics of PHCS while ultrasound is the first imaging examination for hepatic disease. Contrastenhancedultrasound (CEUS) is a proven method that improves the detection and characterization of focal liver lesions. The purpose of the paper is to present the ultrasonographic and other imaging appearance of three cases of PHCS.
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Affiliation(s)
- Chunrui Liu
- Department of Ultrasound, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School,Nanjing, China.
| | - Shuping Wei
- Department of Ultrasound, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School,Nanjing, China.
| | - Min Wu
- Department of Ultrasound, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | - Wentao Kong
- Department of Ultrasound, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
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Abstract
Carcinosarcomas, are very rare tumors in gastrointestinal tract, and at the ampulla of Vater location, are extremely uncommon. They are also called spindle cell carcinomas or sarcomatoid carcinomas. These tumors have an aggressive clinical course with frequent metastasis. We report the case of a male patient of 64 y.o with anemia and jaundice, and a diagnosis of carcinosarcoma of the ampulla of Vater.
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Tsuji K, Ito A, Kurokawa S, Nakaya T, Yoshimoto T, Kawata H, Tamba-Sakaguchi M, Fukushima N, Oshiro H. Primary carcinosarcoma of the ureteropelvic junction associated with ureteral duplication: A case report. Medicine (Baltimore) 2019; 98:e16643. [PMID: 31393362 PMCID: PMC6708839 DOI: 10.1097/md.0000000000016643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Primary carcinosarcoma of the upper urinary tract is rare. Ureteral duplication is one of the most common urinary tract malformations. Additionally, the association between ureteral duplication and malignancy is unknown. To the best of our knowledge, no cases of malignant tumors diagnosed as carcinosarcoma with ureteral duplication have been reported. We herein report the case of a patient with carcinosarcoma of the ureteropelvic junction associated with incomplete ureteral duplication. PATIENT CONCERNS A 60-year-old Japanese woman presented with painless gross hematuria. She had a history of total hysterectomy and chemotherapy for endometrioid carcinoma 5 years before. She had no history of occupational chemical exposure. DIAGNOSES Radiographic imaging revealed right incomplete ureteral duplication, hydronephrosis, and a polypoid tumor in the ureteropelvic junction of the lower moiety of the right kidney. Urine cytology showed a small amount of degenerated atypical epithelial and nonepithelial cells. The transureteral biopsy specimen showed dysplastic urothelial cells and atypical myoid spindle cells. These findings were indefinite for malignancy. INTERVENTIONS The patient underwent right nephroureterectomy. Pathological examination of the resected tumor showed a biphasic neoplasm composed of carcinomatous and sarcomatous components. The sarcomatous component was immunohistochemically positive for vimentin, desmin, h-caldesmon, and α-SMA and negative for pancytokeratin (AE1/AE3), low molecular weight cytokeratin (CAM 5.2), EMA, E-cadherin, GATA3, uroplakin 2, and p63. Based on these findings, we diagnosed the tumor as carcinosarcoma. OUTCOMES The postoperative course was uneventful. No additional therapy was administered. The patient has remained alive without recurrence for 21 months since surgery. LESSONS Carcinosarcoma can arise from ureteral duplication. Although the majority of carcinosarcomas of the upper urinary tract are diagnosed at an advanced stage and have a poor prognosis, some can have a less aggressive course. Further studies are needed to determine the association between ureteral duplication and malignancy.
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Affiliation(s)
- Kentaro Tsuji
- Department of Diagnostic Pathology, Jichi Medical University Hospital
| | - Atsushi Ito
- Department of Diagnostic Pathology, Jichi Medical University Hospital
| | - Shinsuke Kurokawa
- Department of Urology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Takeo Nakaya
- Department of Diagnostic Pathology, Jichi Medical University Hospital
| | | | - Hirotoshi Kawata
- Department of Diagnostic Pathology, Jichi Medical University Hospital
| | | | | | - Hisashi Oshiro
- Department of Diagnostic Pathology, Jichi Medical University Hospital
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21
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Liu Y, Hao H, Guo X, Xu J, Kang L, Zheng G, Zhao H. Rare pancreatic carcinosarcoma in a patient with medical history of esophageal cancer: A case report and literature review. Medicine (Baltimore) 2019; 98:e15238. [PMID: 31008956 PMCID: PMC6494381 DOI: 10.1097/md.0000000000015238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RATIONALE Pancreatic carcinosarcoma (PCS) is a very rare pancreatic cancer with an extremely poor prognosis. Interestingly, PCS can coexist with other metachronous malignant cancers. Here we report a case of PCS combined with esophageal cancer (EC). PATIENT CONCERNS The patient was a 66-year-old man who presented with abdominal pain and progressive nausea. He had undergone esophagectomy for EC 5 years previously. DIAGNOSIS Both EC and PCS were confirmed via postoperative pathological diagnosis. INTERVENTIONS Owing to the patient's previous esophagectomy for EC, pancreaticoduodenectomy for the PCS could not be performed. Instead, he underwent cholecystectomy with bile duct-jejunum Roux-en-Y anastomosis and radioactive seed implantation. OUTCOMES The patient is still alive for >1 year. LESSONS To our knowledge, this is the first report of PCS combined with EC and thus of metachronous multiple primary carcinoma. A detailed literature review of the clinical and histologic features of PCS reveals important information about the epidemiology and biology of this rare disease.
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Affiliation(s)
- Yang Liu
- Department of Pathology, Hebei General Hospital
| | - Han Hao
- Department of Pharmacology, Hebei Medical University
| | - Xiaowan Guo
- Department of Image, Hebei General Hospital, Shijiazhuang
| | - Jieping Xu
- Tianjin Hexi Women & Children Healthcare Center, Tianjin, China
| | - Lin Kang
- Department of Pathology, Hebei General Hospital
| | - Guona Zheng
- Department of Pathology, Hebei General Hospital
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22
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Dueholm M, Hjorth IMD, Dahl K, Pedersen LK, Ørtoft G. Identification of endometrial cancers and atypical hyperplasia: Development and validation of a simplified system for ultrasound scoring of endometrial pattern. Maturitas 2019; 123:15-24. [PMID: 31027672 DOI: 10.1016/j.maturitas.2019.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/02/2019] [Accepted: 01/31/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To derive and validate a practical scoring system for identification of endometrial cancer (EC) or atypical hyperplasia (AH) using transvaginal ultrasonography (TVS) and gel infusion sonography (GIS) in women with postmenopausal bleeding (PMB). STUDY DESIGN Endometrial pattern was correlated with endometrial pathology in consecutive women with PMB in both a derivation study (N = 164) and a validation study (N = 711). Logistic regression was used to derive and validate two scoring systems (A and B) for prediction of EC/AH: scoring system A was Doppler score + interrupted endo-myometrial junction (IEJ) (2 points); and scoring system B was Doppler score + IEJ (1 point) + Irregular Endometrial Outline (IESO) by GIS (1 point); the Doppler score was based on the presence of more than one single or double vessel (1 point) + multiple vessels (1 point) + large vessels (1 point). OUTCOME MEASURES Diagnostic performance and calibration curves for identification of EC/AH. RESULTS Both scoring systems had good observer agreement. VALIDATION DATA Scoring was most effective with endometrial thickness (ET) ≥ 8 mm. Both scoring systems were well calibrated and performed satisfactorily in women with ET ≥ 8 mm. The sensitivity and specificity of a score of ≥ 2 points in system A were 92% and 84%; the respective values were 89% and 88% in system B. CONCLUSIONS Scoring was highly efficient in identifying EC/AH. Four risk groups of EC/AH may guide the management of women with PMB: very low (ET < 4 mm), low (ET 4-7.9 mm), intermediate (ET ≥ 8 mm and score < 2 points) and high risk (ET ≥ 8 mm and score ≥ 2 points).
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MESH Headings
- Aged
- Carcinoma, Endometrioid/complications
- Carcinoma, Endometrioid/diagnostic imaging
- Carcinoma, Endometrioid/pathology
- Carcinosarcoma/complications
- Carcinosarcoma/diagnostic imaging
- Carcinosarcoma/pathology
- Endometrial Hyperplasia/complications
- Endometrial Hyperplasia/diagnostic imaging
- Endometrial Hyperplasia/pathology
- Endometrial Neoplasms/complications
- Endometrial Neoplasms/diagnostic imaging
- Endometrial Neoplasms/pathology
- Endometrium/diagnostic imaging
- Female
- Humans
- Hysteroscopy
- Logistic Models
- Middle Aged
- Myometrium/diagnostic imaging
- Neoplasms, Cystic, Mucinous, and Serous/complications
- Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Postmenopause
- Sensitivity and Specificity
- Ultrasonography
- Ultrasonography, Doppler
- Uterine Hemorrhage/etiology
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Affiliation(s)
- M Dueholm
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark.
| | - I M D Hjorth
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
| | - K Dahl
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
| | - L K Pedersen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - G Ørtoft
- Department of Gynecology and Obstetrics, Copenhagen University Hospital, City, Copenhagen, Denmark
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Kimura K, Hayashi Y, Otani K, Tsujii Y, Iijima H, Isohashi F, Ogawa K, Takehara T. Esophageal carcinosarcoma that disappeared pathologically by palliative radiotherapy alone. Clin J Gastroenterol 2019; 12:247-253. [PMID: 30649679 DOI: 10.1007/s12328-019-00933-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/08/2019] [Indexed: 12/25/2022]
Abstract
Only a few cases of esophageal granulocyte-colony-stimulating-factor (G-CSF)-producing esophageal carcinosarcoma are reported, and patients with G-CSF-producing tumors are typically considered to have poor prognosis. An 89-year-old man was examined for low-grade fever and dysphagia. Chest computed tomography revealed a huge 80-mm tumor on the thoracic esophagus without direct invasion to surrounding organs. Esophagogastroduodenoscopy (EGD) showed a huge mass occupying the esophageal lumen with a superficial flat lesion. Histopathological examination revealed that the tumor was composed of bizarre giant cells and pleomorphic spindle cells with hyperchromatic nuclei. Laboratory data showed aberrant elevation of leukocyte and neutrophil counts and G-CSF levels. The tumor was finally diagnosed as a G-CSF-producing esophageal carcinosarcoma, stage II (T2N0M0, Union for International Cancer Control-TNM Classification of Malignant Tumors, 8th edition). Considering his general condition, we performed palliative radiotherapy (45 Gy/15 fr) alone after consultation with surgeons and radiation oncologists. Follow-up EGD demonstrated the disappearance of the tumor, and the histological assessment of biopsy specimens confirmed no evidence of malignancy. The leukocyte count and G-CSF levels decreased within normal range. This is a very rare case of G-CSF-producing esophageal carcinosarcoma in which a pathologically complete response was achieved using palliative radiotherapy alone.
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Affiliation(s)
- Keiichi Kimura
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Yoshito Hayashi
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Keisuke Otani
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiki Tsujii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Hideki Iijima
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Fumiaki Isohashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
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Abstract
BACKGROUND Sarcomatoid hepatocellular carcinoma (SHC) is a rare malignant hepatic tumor. Recurrent interventional therapies such as transcatheter arterial chemo-embolization (TACE), radiofrequency ablation (RFA), and percutaneous ethanol injection have been reported previously utilized in a majority of SHC cases. To date, the exact pathogenic mechanisms underlying sarcomatoid transformation of hepatocellular carcinoma (HCC) remain unknown. CASE PRESENTATION In this study, we report a 68-year-old female SHC patient admitted to our hospital due to discrete abdominal distention for more than 20 days. Abdominal computed tomography (CT) with tri-phase enhancement revealed portal vein tumor thrombi (PVTT) and a left hepatic lobe lesion measuring 110.0 mm × 160.0 mm. The patient subsequently underwent liver resection, after which pathological examination revealed proliferation of spindle-shaped SHC cells. A sarcomatoid, T4 stage carcinoma was eventually diagnosed. Forty-seven days after the operation, tri-phase enhanced CT detected extensive lesions in the liver, spleen, peritoneum, omentum majus, and mesentery, indicating SHC recurrence and metastases. Combination chemotherapy with pirarubicin and cisplatin was initiated for 1 cycle, but terminated due to resultant severe myelosuppression and medication intolerance. The patient was lost to therapy after 3 months of follow-up. CONCLUSIONS This case is unique because of hepatitis C virus infection. We should consider the possibility of this disease in patients with atypical clinical presentation.
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Affiliation(s)
- Yingying Yu
- Department of Oncology, First Hospital of Jilin University, 71 Xinmin St., Changchun, Jilin 130012 China
| | - Yanping Zhong
- Department of Pathology, First Hospital of Jilin University, Changchun, Jilin 130012 China
| | - Jingyu Wang
- Department of Radiology, First Hospital of Jilin University, Changchun, Jilin 130012 China
| | - Di Wu
- Department of Oncology, First Hospital of Jilin University, 71 Xinmin St., Changchun, Jilin 130012 China
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Arshad HS, Dudekula RA, Niazi M, Malik S, Khaja M. A Rare Case of Sarcomatoid Carcinoma of the Lung with Spine Metastasis, Including a Literature Review. Am J Case Rep 2017; 18:760-765. [PMID: 28684728 PMCID: PMC5510997 DOI: 10.12659/ajcr.904584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 04/27/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Sarcomatoid carcinoma is a rare, aggressive, malignant cancer composed of sarcoma and sarcoma-like components, and can occur in different organs such as the thyroid gland, bone, skin, breast, pancreas, liver, urinary tract, and lung. Pulmonary sarcomatoid carcinoma accounts for only a small percentage of lung cancers and has histological variants that include pleomorphic carcinoma, giant cell carcinoma, spindle cell carcinoma, carcinosarcoma, and pulmonary blastoma. CASE REPORT Here, we present a case of sarcomatoid carcinoma in a 63-year-old HIV-positive Hispanic male who presented with back pain, dry cough, and weight loss. A CT scan of his chest showed an ovoid mass in the lower lobe of the left lung, and an MRI of the spine showed a left lateral paraspinal soft tissue mass causing central canal stenosis and mild cord compression. The patient underwent laminectomy and resection of the spinal mass. A transthoracic needle biopsy of the lung and spinal masses had similar histopathology, and were indicative of sarcomatoid carcinoma. CONCLUSIONS We report a rare case of sarcomatoid carcinoma involving both the lung and spinal cord in the same patient. Sarcomatoid carcinomas of the lung have poor prognosis and are aggressive cancers. Moreover, our case also had the co-occurrence of HIV and sarcomatoid carcinoma.
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Affiliation(s)
- Hafiza Sobia Arshad
- Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, U.S.A
| | - Rizwan Ahmed Dudekula
- Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, U.S.A
| | - Masooma Niazi
- Division of Pathology, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, U.S.A
| | - Sandeep Malik
- Division of Hematology and Oncology, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, U.S.A
| | - Misbahuddin Khaja
- Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, U.S.A
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Mszyco S, Teng L, Annunziata J, Hartman MS. Pancreatic Carcinosarcoma: A Case Report Highlighting Computed Tomography Characteristics. Curr Probl Diagn Radiol 2017; 46:342-345. [PMID: 28318763 DOI: 10.1067/j.cpradiol.2017.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 01/23/2023]
Abstract
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague right upper quadrant and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation. Although specific radiologic diagnosis of this entity is not possible, bringing the possibility of primary pancreatic carcinosarcoma to the ordering clinician׳s attention has the potential to hasten treatment and improve patient outcomes. We review the current literature on this rare type of neoplasia, considering histopathologic and clinical features. This case highlights the importance of radiologist awareness of this rare neoplasm and to consider carcinosarcoma in the differential when presented with a mixed solid and cystic pancreatic mass.
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Affiliation(s)
- Steven Mszyco
- Department of Radiology, Dartmouth-Hitchcok Medical Center, Lebanon, NH.
| | - Leslie Teng
- Department of Radiology, Allegheny Health Network, Pittsburgh, PA
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Barral M, Placé V, Dautry R, Bendavid S, Cornelis F, Foucher R, Guerrache Y, Soyer P. Magnetic resonance imaging features of uterine sarcoma and mimickers. Abdom Radiol (NY) 2017; 42:1762-1772. [PMID: 28246921 DOI: 10.1007/s00261-017-1076-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Uterine myometrial tumors are predominantly benign conditions that affect one-third of women and represent the main indication for hysterectomy. Preoperative imaging is of utmost importance for characterization and for precise mapping of myometrial tumors to best guide therapeutic strategy. New minimally invasive therapeutic strategies including morcellation, myolysis, uterine artery embolization and image-guided radiofrequency or focused ultrasound ablation have been developed for the treatment of uterine leiomyoma. However, preoperative differentiation between atypical leiomyomas and leiomyosarcomas is critical on imaging as uterine sarcoma requires a specific surgical technique to prevent dissemination. A single, rapidly growing uterine tumor, associated with endometrial thickening and ascites, in post-menopausal women is suspicious of uterine endometrial stromal sarcoma and carcinosarcoma. Suggestive magnetic resonance imaging features have been described, but overlap in imaging appearance between uterine leiomyosarcomas and cellular leiomyomas makes it challenging to ascertain the diagnosis. This review aims to illustrate the imaging features of uterine sarcomas and potential mimickers to make the reader more familiar with this serious condition which needs special consideration.
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Affiliation(s)
- Matthias Barral
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France.
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique- Hôpitaux de Paris, 2 rue Ambroise Paré, 75475, Paris, France.
- Inserm U-965, CART, Carcinose Angiogénèse et recherche translationnelle, 41 bvd de La Chapelle, 75010, Paris, France.
| | - Vinciane Placé
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| | - Raphaël Dautry
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| | - Sandra Bendavid
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| | - Françoise Cornelis
- Department of Pathology, Hôpital Lariboisière, Assistance Publique- Hôpitaux de Paris, 2 rue Ambroise Paré, 75475, Paris, France
| | - Romain Foucher
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique- Hôpitaux de Paris, 2 rue Ambroise Paré, 75475, Paris, France
| | - Youcef Guerrache
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| | - Philippe Soyer
- Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique- Hôpitaux de Paris, 2 rue Ambroise Paré, 75475, Paris, France
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Gu KW, Kim YK, Min JH, Ha SY, Jeong WK. Imaging features of hepatic sarcomatous carcinoma on computed tomography and gadoxetic acid-enhanced magnetic resonance imaging. Abdom Radiol (NY) 2017; 42:1424-1433. [PMID: 28078380 DOI: 10.1007/s00261-016-1038-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To determine the imaging features of hepatic sarcomatous carcinoma including sarcomatous intrahepatic cholangiocarcinoma (S-ICC) and sarcomatous hepatocellular carcinoma (S-HCC) on computed tomography (CT) and gadoxetic acid-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty-four patients with pathologically confirmed S-ICCs (n = 13), S-HCCs (n = 7), sarcomatous carcinoma (n = 2), carcinosarcoma (n = 1), and sarcomatous combined HCC-CC (n = 1) (size range 2.1-23 cm, mean 8.3 cm) underwent gadoxetic acid-enhanced MRI (n = 20) and/or dynamic CT (N = 24). Underlying chronic hepatitis or cirrhosis was found in 17 patients. Two reviewers evaluated morphology, signal intensity, and enhancement features of tumors based on a consensus. RESULTS Lobulated contour was observed in 15 tumors (62.5%); the rest were round or oval masses. During dynamic imaging, S-ICCs showed poor enhancement (n = 10 on CT; n = 7 on MRI) or initial thin-rim enhancement with/without progressive enhancement (n = 3 on CT; n = 6 on MRI). S-HCCs and the other four tumors showed a thin or thick enhancement pattern on both CT and MRI. T2 bright signal intensity similar to fluid was found in 10 tumors. Target appearance on hepatobiliary phase and diffusion-weighted imaging was seen in two S-ICCs and two S-HCCs. Of 18 surgically resected tumors, 17 showed vascular invasion and/or thrombosis in histology and 12 in CT and MRI. Ten tumors were accompanied by intrahepatic metastasis or tumor seeding and 19 patients had recurrence or progression of tumors during follow-up. CONCLUSION Hepatic sarcomatous carcinoma including S-HCC and S-ICC generally presents minimal rim-like arterial enhancement or extreme hypovascularity on CT and gadoxetic acid-enhanced MRI with a high frequency of T2 bright area due to extensive necrosis and vascular invasion.
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Affiliation(s)
- Kyo-Won Gu
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Kon Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Ji Hye Min
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Yun Ha
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Mjid M, Toujani S, Blibech H, Hedhli A, Ouahchi Y, Haouet S, Cherif J, Beji M. [A rare pulmonary tumor: Primary carcinosarcoma of the lung]. Rev Pneumol Clin 2016; 72:381-384. [PMID: 27789162 DOI: 10.1016/j.pneumo.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/29/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Affiliation(s)
- M Mjid
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie; Service de pneumologie, hôpital La Rabta, bab Saadoun, 1007, Tunis, Tunisie.
| | - S Toujani
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - H Blibech
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - A Hedhli
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - Y Ouahchi
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - S Haouet
- Service d'anatomopathologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - J Cherif
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - M Beji
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
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Howard SN, Bond WR, Hong IS, Foss RD. Right Maxillary Sinus Sarcomatoid Carcinoma (Sarcomatoid/Spindle Cell Carcinoma). Otolaryngol Head Neck Surg 2016; 137:355-7. [PMID: 17666274 DOI: 10.1016/j.otohns.2007.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Accepted: 03/02/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Scott N Howard
- Department of ENT, Walter Reed Army Medical Center, Washington, DC, USA
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Birla R, Catanescu ER, Caragui A, Constantinoiu S. Mature Teratoma Associated with Bilateral Ovarian Carcinosarcoma - Accidental Association or Etiopathogenetic Determinism? - Case Report. Chirurgia (Bucur) 2016; 111:422-427. [PMID: 27819640 DOI: 10.21614/chirurgia.111.5.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
Abstract
Carcinosarcoma is a rare form of ovarian cancer with mixed origin, and its association with mature teratoma is extremely rare. We present the case of patient T. M. aged 67, admitted into our clinic on the 15/05/2016, F.O. 4877 for the increase of the abdominal volume. On admission, the patient was afebrile, conscious, cooperative, cardio-respiratory balanced, having the abdomen distended in volume, sharp dullness in the flanks, positive wave sign bioumoral within normal limits except: uric acid = 6.64 mg / dL, serum glucose = 113.7 mg / dl, serum total proteins = 8.65 g / dl, the albumin / globulin subunit, CRP 33.63 mg / l, sideremia 51 ug / dl, CA 125 = 588.4 IU. Abdominal ultrasound: high volume fluid and multiple perihepatic formations and multiple formations with cystic transformation in the abdomen and pelvis. CT exam describes multiple tissular masses localized intraperitoneal in the abdominal-pelvic region, sheath fluid effusion, infiltrative, with mass effect on the digestive lumens, without visible CT obstruction. Surgical treatment consisted in evacuation of the ascites fluid, excision of the tumoral lumps situated in the great omentum, omentectomy, excision of the lumps of the gastrocolic ligament, bilateral ovariectomy and hysterectomy. Postoperative simple evolution. Histopathology confirmed the diagnosis of bilateral ovarian carcinosarcoma associated with tridermic mature teratoma (presence of brain tissue areas associated with cartilage, transitional type epithelium, tubal type epithelium, endometrial stroma type and fatty tissue). IHC confirms the compatibility with the diagnosis of ovarian carcinosarcoma (mixed malignant Mullerian tumor). The patient followed adjuvant polichemotherapy. The association of teratoma with carcinosarcomatoase elements confers a poor prognosis case.
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Kazawa N, Shibamoto Y, Kitabayashi Y, Ishihara Y, Gotoh T, Sawada Y, Inukai R, Tsujimura T, Hattori H, Niimi A, Nakanishi R, Kitaichi M. [Pulmonary Carcinosarcoma Presenting Hemothorax Caused by Pleural Invasion;Report of a Case]. Kyobu Geka 2016; 69:1045-1047. [PMID: 27821833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 71-year-old man presented with hemothorax with cough, sputa and worsening dyspnea. On chest X-ray and computed tomography(CT), a huge tumor in the right upper lobe with hematoma and small amount of gas suggesting hemopneumothorax was revealed. No apparent lymphadenopathy nor intrapulmonary metastases were observed. The tumor showed a little enhancement on the contrastenhanced CT. Then the resction of the tumor was performed, and the pathological evaluation revealed a carcionosarcoma (adenocarcinoma+osteosarcoma) pT3N0 (stage II B) G4 pl2. Sarcomatoid carcinoma such as carcinosarcoma should be considered as a possible cause of hemothorax in making a diagnosis of hemorrhagic hypovascular huge lung tumor.
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Affiliation(s)
- Nobukata Kazawa
- Department of Radiology, Nagoya City University, Nagoya, Japan
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Takeuchi M, Matsuzaki K, Harada M. Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy. Acta Radiol 2016; 57:1277-84. [PMID: 26787673 DOI: 10.1177/0284185115626475] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/24/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Recently carcinosarcoma has become regarded as a subset of endometrial carcinoma. Because the clinical course of carcinosarcoma is aggressive with poor prognosis, it should be differentiated from endometrial carcinomas for the appropriate surgical management and adjuvant therapy. PURPOSE To clarify the magnetic resonance imaging (MRI) characteristics of uterine carcinosarcoma including diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement and MR spectroscopy (MRS) with quantitative metabolite evaluation. MATERIAL AND METHODS MRI findings of 12 pathologically diagnosed uterine carcinosarcomas obtained on 3T MRI were retrospectively evaluated. The mean and minimum ADCs, and the lipid and choline concentration levels were compared with those of pathologically diagnosed 38 endometrial carcinomas. RESULTS The mean and minimum ADCs in carcinosarcomas and endometrial carcinomas were not significantly different. The mean ADC of carcinosarcomas was significantly higher than that of higher grade (G2 and G3) endometrial carcinomas. The choline concentration in carcinosarcomas was significantly lower than that in endometrial carcinomas. High lipid peak was observed in 91% of carcinosarcomas and in 24% of endometrial carcinomas. CONCLUSION Large, exophytic heterogeneous endometrial mass containing strongly enhanced areas, which may exhibit "tumor delivery", is a suggestive of carcinosarcoma. Relatively high mean ADC and low choline concentration considering its highly malignant nature due to intra-tumoral heterogeneity with necrosis and epithelial cystic components, and the presence of necrosis-associated high lipid peak may be compatible with carcinosarcoma.
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Affiliation(s)
- Mayumi Takeuchi
- Department of Radiology, University of Tokushima, Tokushima, Japan
| | - Kenji Matsuzaki
- Department of Radiology, University of Tokushima, Tokushima, Japan Department of Radiological Technology, Tokushima Bunri University, Kagawa, Japan
| | - Masafumi Harada
- Department of Radiology, University of Tokushima, Tokushima, Japan
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Smadhi H, Ben Hamad W, Neffati O, Kammoun H, Braham E, Fekih L, Megdiche ML. [A rare cause of a posterior mediastinal mass]. Rev Pneumol Clin 2016; 72:160-162. [PMID: 26190341 DOI: 10.1016/j.pneumo.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/04/2015] [Accepted: 04/30/2015] [Indexed: 06/04/2023]
Affiliation(s)
- H Smadhi
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie.
| | - W Ben Hamad
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - O Neffati
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - H Kammoun
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - E Braham
- Service d'anatomie pathologique, hôpital Abderrahman Mami Ariana, 2080, Tunisie; Faculté de médecine de Tunis, université Tunis Elmanar II, 1006 Tunisie
| | - L Fekih
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - M L Megdiche
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
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Páramo AA, Valverde DP, Campos PV, Santos EPG, Puche JLB, Guerrero PN, Delgado M, Fernindez JM. [Syncrhonous carcinosarcoma of the extrahepatic bile duct and gallbladder.]. Acta Gastroenterol Latinoam 2016; 46:30-34. [PMID: 29470881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Carcinosarcoma is a malignant neoplasm characterized for intermingled epithelial and mesenchymal components. CASE REPORT A preoperative suspected diagnosis will allow a radical therapy avoiding a very bad prognosis. We report on a male patient who was operated in our Service with diagnosis of synchronous carcinosarcoma of gallbladder and extrahepatic bile duct and a review of the Medical Literature. DISCUSSION A gallblader carcinosarcoma showing extension into common bile duct is very rare, a carcinosarcoma of the bile duct is exceptional, and a synchronous carcinosarcoma ofthe bile duct and gallbladder has not been reported previously.
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Shi HY, Xie J, Miao F. Pancreatic carcinosarcoma: First literature report on computed tomography imaging. World J Gastroenterol 2015; 21:1357-1361. [PMID: 25632213 PMCID: PMC4306184 DOI: 10.3748/wjg.v21.i4.1357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/06/2014] [Accepted: 09/30/2014] [Indexed: 02/06/2023] Open
Abstract
Carcinosarcoma of the pancreas is an extremely rare tumor and has a dismal prognosis. To the best of our knowledge, the histopathological features of the lesion have been illustrated in the literature but to date no reported cases have been documented on imaging characteristics. We report a female case of pancreatic carcinosarcoma presenting as a mucinous cystadenoma on computed tomography (CT). We also summarize the CT characteristics according to the appended CT images in the reported cases. This is the first report of CT features of pancreatic carcinosarcoma in the English literature.
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Liu LP, Yu XL, Liang P, Dong BW. Characterization of primary hepatic carcinosarcoma by contrast-enhanced ultrasonography: A case report. World J Gastroenterol 2014; 20:1630-1634. [PMID: 24587642 PMCID: PMC3925875 DOI: 10.3748/wjg.v20.i6.1630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/08/2013] [Accepted: 12/04/2013] [Indexed: 02/06/2023] Open
Abstract
Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confirmed by pathology following surgical resection. Using contrast-enhanced ultrasonography, the tumor showed peripheral nodular hyperenhancement in the arterial phase with two feeding arterial vessels and a large internal non-enhancing portion in the center. The peripheral nodular portion of the tumor showed hypoenhancement in the later phase.
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Ishida M, Kodama N, Takemura Y, Iwai M, Yoshida K, Kagotani A, Matsusue Y, Okabe H. Primary bone carcinosarcoma of the fibula with chondrosarcoma and squamous cell carcinoma components. Int J Clin Exp Pathol 2013; 6:2216-2223. [PMID: 24133601 PMCID: PMC3796245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 08/29/2013] [Indexed: 06/02/2023]
Abstract
Carcinosarcoma is defined as a malignant neoplasm that is composed of both carcinomatous and sarcomatous components. The occurrence of carcinosarcoma in the bone is extremely rare. In this report, we describe the third documented de novo case of carcinosarcoma of the bone. A 59-year-old Japanese female presented with a painful tumor in her right lower leg. Plane radiography revealed an osteolytic destructive lesion with periosteal reaction and mineralization in the right fibula. Resection of the fibula tumor was performed under a clinical diagnosis of chondrosarcoma. Histopathological study revealed that the tumor was comprised of three components. The main component was proliferation of small round to short spindle cells (approximately 50%), and the remaining components were chondrosarcoma (30%) and squamous cell carcinoma (20%). Immunohistochemically, SOX9 was expressed in the small round to spindle cells and chondrosarcoma component, and p63 and p40 were expressed in all three components. Accordingly, an ultimate diagnosis of carcinosarcoma of the bone was made. The clinicopathological analysis of carcinosarcoma of the bone revealed that this type of tumor affects the middle-aged to elderly persons and occurs in the long bone. All three de novo cases had chondrosarcoma and squamous cell carcinoma components. One of the 3 patients died of the disease. The histogenesis of carcinosarcoma of the bone remains a matter of controversy, although a multpotential stem cell theory has been proposed. Additional studies are required to clarify the clinical behavior and histogenesis of carcinosarcoma of the bone.
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Affiliation(s)
- Mitsuaki Ishida
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical ScienceShiga, Japan
| | - Narihito Kodama
- Department of Orthopedic Surgery, Shiga University of Medical ScienceShiga, Japan
| | - Yoshinori Takemura
- Department of Orthopedic Surgery, Shiga University of Medical ScienceShiga, Japan
| | - Muneo Iwai
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical ScienceShiga, Japan
| | - Keiko Yoshida
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical ScienceShiga, Japan
| | - Akiko Kagotani
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical ScienceShiga, Japan
| | - Yoshitaka Matsusue
- Department of Orthopedic Surgery, Shiga University of Medical ScienceShiga, Japan
| | - Hidetoshi Okabe
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical ScienceShiga, Japan
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Mathlouthi N, Belgharbi A, Slimani O, Ben Temime R, Makhlouf T, Attia L, Chachia A. [Uterine carcinosarcoma]. Tunis Med 2013; 91:554-555. [PMID: 24227518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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40
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Fatima SS, Minhas K, Din NU, Fatima S, Ahmed A, Ahmad Z. Sinonasal teratocarcinosarcoma: a clinicopathologic and immunohistochemical study of 6 cases. Ann Diagn Pathol 2013; 17:313-8. [PMID: 23462185 DOI: 10.1016/j.anndiagpath.2013.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/31/2012] [Accepted: 01/22/2013] [Indexed: 11/18/2022]
Abstract
Teratocarcinosarcoma (TCS) is a rare and unusual malignant neoplasm of the sinonasal tract with a heterogenous morphology and an aggressive behavior. Patients are predominantly adults with a male predominance. The aim of this study was to describe clinicopathologic and immunohistochemical features of 6 cases of TCS. The ages ranged from 18 to 67 years (mean, 33 years) with a male-to-female ratio of 5:1. Most tumors were located in the nasal cavity. Nasal obstruction and epistaxis were the common presenting symptoms. Histologically, all tumors exhibited a heterogeneous morphology with varying proportions of benign and malignant epithelial, mesenchymal, and neuroepithelial elements. Adenocarcinoma was the malignant epithelial component in all cases. The mesenchymal elements were composed of benign to malignant spindle cells. Osteosarcomatous areas were seen in 2 cases and rhabdomyosarcoma in 1 case. Rhabdoid differentiation was also seen in 1 case. Immunohistochemical stains CKAE1/AE3 and CK Cam 5.2 were positive in the epithelial elements, vimentin in mesenchymal, and CD56 and neuron-specific enolase in neuroepithelial elements. Follow-up was available in 4 patients and ranged from 21 to 40 months (mean, 31 months). Lung and dura metastasis, respectively, were seen in 1 patient each. However, all 4 patients are alive and free of disease to date. In conclusion, TCS is a rare but highly malignant tumor with aggressive behavior characterized by benign and malignant epithelial, mesenchymal, and neuroepithelial components. Two patients in our series were younger than 20 years. The occurrence of rhabdoid differentiation and osteosarcomatous component seen in our series were rarely described in literature. Recognition of all the components requires adequate sampling, which is crucial for a correct diagnosis.
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Affiliation(s)
- Syeda Samia Fatima
- Department of Pathology and Microbiology, Section of Histopathology, Aga Khan University Hospital, Karachi, Pakistan.
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41
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Li BF, Li PW, Shi R, Liu ZL, Liu YF. Clinicopathologic analysis of gallbladder carcinosarcoma. Am Surg 2013; 79:E37-E39. [PMID: 23317603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Bai-Feng Li
- Department of General Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
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Abstract
Carcinosarcoma is an uncommon mixed tumor of the lung. We present the case of a 65 year-old-male with cough and a right lower lobe radio-opacity who underwent resection, showing a large endobronchial tumor with an epithelial component of non-small cell carcinoma and malignant mesenchymal elements. The radiologic and histopathologic features are reviewed with reference to relevant literature.
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Affiliation(s)
- Carolina Carcano
- Division of Radiology, Cleveland Clinic Florida, Weston, FL, USA.
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43
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Emoto M. [Uterine carcinosarcoma]. Nihon Rinsho 2012; 70 Suppl 4:442-446. [PMID: 23156287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Makoto Emoto
- School of Health Science, International University of Health and Welfare/Fukuoka Sanno Hospital
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44
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Hall AB, Keller LL, Varner L, Naing W, Countryman D, Mitchell JD. Positron emission tomography and carcinosarcoma of the esophagus. Am Surg 2011; 77:128-131. [PMID: 21396330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Andrew B Hall
- Keesler Medical Center, Keesler AFB, Mississippi 39534, USA.
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45
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Sun PP, Zhong DR. [Primary liver carcinosarcoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2010; 39:713-714. [PMID: 21176545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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46
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Lao LF, Sun ZY, Tang J. [Clinicopathological and imaging features of 5 cases of lung sarcomatoid carcinoma and review of the literature]. Zhonghua Zhong Liu Za Zhi 2010; 32:607-608. [PMID: 21122414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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47
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Goto T, Maeshima A, Tajima A, Kato R. A resected case of pulmonary carcinosarcoma. Ann Thorac Cardiovasc Surg 2010; 16:190-193. [PMID: 20930681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Accepted: 04/02/2009] [Indexed: 05/30/2023] Open
Abstract
The patient was a 78-year-old man with a history of smoking 5 or 6 cigarettes per day for 40 years. A chest X-ray taken during a medical checkup demonstrated a mass shadow in the right lower lung field. The patient was diagnosed with squamous cell carcinoma by bronchoscopic brushing cytology. A right lower lobectomy and a lymph node dissection were performed under a diagnosis of squamous cell carcinoma of the lung (cT2N0M0, stage IB). Gross examination of the resected specimen demonstrated an ovoid, irregularly bordered, yellowish-white tumor, 8 cm in diameter, containing a necrotic cavity. Histopathological examination showed diffuse proliferation of spindle-shaped tumor cells intermingled with areas of well-differentiated squamous cell carcinoma with definite keratinization. Areas of cartilage and bone were observed in the spindle-cell components of the tumor. These findings led to a diagnosis of carcinosarcoma (pT2N0M0, stage IB). The patient developed multiple intrapulmonary metastases 5 months after surgery and died of respiratory failure 10 months later. Herein we report a rare surgical case of lung carcinosarcoma.
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Affiliation(s)
- Taichiro Goto
- Department of General Thoracic Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
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48
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Zhang LY, Dai JR. [Imaging features of nonepithelial tumors of the bladder]. Zhonghua Zhong Liu Za Zhi 2009; 31:384-387. [PMID: 19799090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To summarize the imaging features of nonepithelial tumors of the bladder. METHODS The Imaging findings in 20 surgically treated patients with pathologically proved nonepithelial tumors of the bladder were retrospectively analyzed. The tumors included leiomyoma (n = 9), pheochromocytoma (n = 6), leiomyosarcoma (n = 2), rhabdomyosarcoma (n = 1), carcinosarcoma (n = 1), inflammatory myofibroblastoma (n = 1). RESULTS The leiomyomas were round or ellipse in shape with a sharp border and homogeneous density, and showed a low signal intensity on T1WI and T2WI in 1/1 case; slight enhancement on CT after contrast enhancement in 6/7 cases; and a poor blood supply on color Doppler ultrasonography in 3/4 cases. The pheochromocytoma had a round or oval shape and clear border, and slightly lobulated in 4/6 cases, homogeneous density/echo/signal in 5/6 cases, calcification in 1 case, low signal intensity on T1WI and high signal intensity on T2WI in 1/1 case, moderate or marked enhancement on CT and MRI in 4/5 cases, and strong blood supply on color Doppler ultrasonography in 3/4 cases. The inflammatory myofibroblastoma showed the same imaging features as the pheochromocytomas. Other malignant tumors showed an irregular configuration, with a poorly defined border, heterogeneous density/echo/signal and moderate to strong enhancement on CT. CONCLUSION Most leiomyomas and pheochromocytomas of the bladder show some typical imaging features on CT, MRI and ultrasound, which are helpful in making correct diagnosis and treatment plan preoperatively. Other malignant nonepithelial bladder tumors do not show special imaging characteristics and can only be diagnosed qualitatively.
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Affiliation(s)
- Lian-yu Zhang
- Department of Diagnostic Radiology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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49
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Park SH, Lee KH, Kang KJ, Shin DH, Jung HW, Choi SH, Jang KT. [A case of carcinosarcoma in the liver]. Korean J Gastroenterol 2009; 53:198-201. [PMID: 19835222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
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.
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Affiliation(s)
- Sung Hyun Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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50
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Parini CL, Mathis D, Leath CA. Occult metastatic lung carcinoma presenting as locally advanced uterine carcinosarcoma on positron emission tomography/computed tomography imaging. Int J Gynecol Cancer 2007; 17:731-4. [PMID: 17504386 DOI: 10.1111/j.1525-1438.2007.00837.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Increasingly, positron emission tomography/computed tomography (PET/CT) is being used as a tumor surveillance modality for multiple tumor types. A 73-year-old postmenopausal female with stage IV nonsmall cell lung cancer presented after a PET/CT demonstrated focal uptake in the superior and lateral aspects of the uterus. The patient reported a history of intermittent postmenopausal bleeding and an endometrial biopsy documented uterine carcinosarcoma. Postoperative pathologic review and immunohistochemical staining with thyroid transcription factor-1 revealed metastatic adenocarcinoma consistent with her lung primary in her uterus and adnexa. Our case represents a rare occurrence in which lung cancer has metastasized to multiple female pelvic organs. Increasing use of PET/CT may lead to the discovery of occult metastases masquerading as a second primary malignancy.
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Affiliation(s)
- C L Parini
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
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