Cutaneous Carcinosarcoma: a Clinicopathologic and Immunohistochemical Analysis of 11 Korean Cases

BACKGROUND: Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS: We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS: The mean patient age at diagnosis was 71.5 years (range, 43–96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION: Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.

Primary Cutaneous Carcinosarcoma Composed of Squamous Cell Carcinoma and Epithelioid Sarcoma / 대한피부과학회지

Cutaneous carcinosarcoma is a biphasic, rare tumor composed of malignant epithelial and mesenchymal components. The most common carcinoma component is a squamous cell carcinoma and the most common sarcoma component is an osteosarcoma. A 74-year-old female patient presented to our hospital with a 3.5x3.5 cm-sized exophytic, eroded tumor surrounded by an erythematous plaque on her right flank that had been present for 10 years. On the incisional biopsy specimen, the tumor was composed of atypical malignant squamous cells and epithelioid cells. Furthermore, immunohistochemistry revealed that the tumor cells were positive to cytokeratin AE1/AE3, cytokeratin 5/6, epithelial membrane antigen, p63, and vimentin but were negative to HMB45, S-100, CD31, CD34, factor VIII, smooth muscle actin, and desmin. Finally, based on these histopathological and immunohistochemical findings, we diagnosed this tumor as cutaneous carcinosarcoma consisting of squamous cell carcinoma and epithelioid sarcoma.

A Case of Cutaneous Carcinosarcoma / 대한피부과학회지

Carcinosarcoma is a biphasic tumor that has both epithelial as well as mesenchymal components. It most commonly occurs at the esophagus, lung, upper respiratory tract and urinary bladder, however it rarely occurs on the skin. A 62-year-old men presented with a bean sized crusted ulcer on his right cheek. A biopsy specimen revealed atypical sqamous cells mixed with spindle-shaped cells with hyperchromatic nuclei. Furthermore, immunohistochemical study showed positive reactions for AE1/AE3, cytokeratin7, epithelial membrane antigen and vimentin, but negative reactions for S100 protein, CD34 and smooth muscle actin. Based on these histopathological and immunohistochemical findings, we diagnosed this case as cutaneous carcinosarcoma. The patient was treated with complete excision and a local flap.