A Case of Mucoepidermoid Carcinoma Mixed with Osteosarcoma of the Parotid Gland Extending to the Parapharyngeal Space / 대한이비인후과학회지

Carcinosarcomas, also known as true malignant mixed tumors, are rare tumors of the salivary gland and are composed of both malignant epithelial and malignant mesenchymal elements. They may occur in pre-existing pleomorphic adenomas or arise de novo. Here we report the first case of carcinosarcoma of the parotid gland composed of mucoepidermoid carcinoma and osteosarcoma. The tumor had originated from the parotid gland and extended into the parapharyngeal space. To the best of our knowledge, there have been no reports on mucoepidermoid carcinoma mixed with osteosarcoma ex pleomorphic adenoma in the parotid gland.

Carcinosarcoma of parotid gland - A rare case report.

Carcinosarcoma (true malignant mixed tumor) is an extremely rare tumor of the salivary gland. It is a biphasic tumor and is composed of both malignant epithelial and malignant mesenchymal component. Commonly, squamous cell carcinoma and adenocarcinoma forms the epithelial component and chondrosarcoma forms the mesenchymal component. We, hereby, report a parotid lesion in a 47 year old female that contained adenocarcinoma as epithelial component and chondrosarcoma as mesenchymal component. We report this unusual case of carcinosarcoma of parotid gland due to its rarity. It mimics benign lesions on ultrasonographic examination. On fine needle aspiration, the diagnosis of carcinosarcoma can be missed, as was in our case where it was reported as pleomorphic adenoma with atypical features. Histopathology only gives confirmatory diagnosis. In addition, a short review of literature along with possible pathogenesis of malignant mixed tumor of salivary gland is also presented.

Pleomorphic Adenoma with Sarcomatous Change in a Lacrimal Gland

A 69-year-old man was referred with left exophthalmos. Computed tomographic (CT) findings detected a well-circumscribed mass in the left side of the intraorbital cavity. At that time, he refused the further evaluation and treatment. About three years later, the size of the mass had enlarged, and the patient's symptoms were getting worse. The mass was completely removed with frontotemporal craniotomy and superolateral orbitotomy. In operative findings, the mass had originated in the lacrimal gland and was well-encapsulated without invasion to the surrounding tissue. In the pathologic findings, the tumor consisted of pleomorphic adenoma with osteosarcomatous change of stromal components. Postoperatively, the adjuvant radiotherapy was done four weeks later. The patient's symptoms were improved. The pleomorphic adenoma with osteosarcomatous change is extremely rare and appropriate treatment is not clearly established. We would like to report this rare case with a review of the literature.

A Case of Carcinoma Ex Pleomorphic Adenoma at 1st Operation

PURPOSE: To report a case of carcinoma ex pleomorphic adenoma observed during the patient's first operation. CASE SUMMARY: A 63-year-old female presented with proptosis and ptosis that was aggravated 1 year prior. On preoperative CT image, a 32 x 20 x 21 mm-sized well demarcated mass (suspected as pleomorphic adenoma) was observed and was removed entirely by anterolateral orbitotomy. The excised mass surface was uneven but the capsule appeared intact on gross examination. Hard, yellow-colored and soft, dark-colored materials were found concurrently on cross section. The histological examination showed malignant cells as part of the soft material and was diagnosed as carcinoma ex pleomorphic adenoma. CONCLUSIONS: We report a case of carcinoma ex pleomorphic adenoma of the lacrimal gland that presented with malignant change during the patient's first operation. Supposedly, during the process of mass growth, minimal rupture occurred causing malignant transformation. Clinically, although a mass is believed benign based on imaging, the possibility of malignant transformation of a tumor increasing rapidly or enlargement causing development of rapid proptosis should be considered.

A Case of Giant Carcinosarcoma of the Parotid Gland / 대한이비인후과학회지

Carcinosarcoma, or true malignant mixed tumor of the salivary gland, is a very rare malignant tumor comprised of both carcinomatous and sarcomatous elements and accounts for only 0.04-0.16% of all salivary gland tumors. Carcinosarcoma usually occurs in the parotid gland. Other locations including submandibular gland, minor salivary gland, uterus, bladder or lung have been reported. We report a rare case of carcinosarcoma of the parotid gland in an 85-year-old female. The tumor was large, about 19x17 cm in size, and was successfully excised.

A Case of Carcinosarcoma of the Parotid Gland / 대한이비인후과학회지

Carcinosarcoma is an extremely rare tumor, composed of a mixture of both carcinomatous and sarcomatous elements. The two-thirds are derived from the parotid gland. Because carcinosarcoma is highly aggressive malignant tumor with high local recurrence and poor survival rates, the combination of radical surgical excision and chemotherapy or radiotherapy is regarded as treatment of choice. However, treatment protocol has not been established. A 73-year-old man presented with a painful mass in the left parotid gland that had been rapidly enlarging for 2 weeks. Fine-needle aspiration biopsy was performed and it showed atypical epithelium. Superficial parotidectomy and modified radical neck dissection were performed for the left parotid gland cancer. The pathological diagnosis was carcinosarcoma and sequential chemoradiotherapy was performed. After a clinical follow-up of 30 months, he has remained free of disease. Based on our experience, we suggest that conservative surgical procedure could be one of the effective therapies.

Atypical Pulmonary Metastases from a True Malignant Mixed Tumor of the Parotid Gland

A 58-year-old male patient presented with a recurrent true malignant mixed tumor of the parotid gland. Patchy pulmonary opacities were identified with a chest radiograph. Subsequently, a CT scan of the chest showed pulmonary parenchymal consolidation with amorphous calcifications. This abnormality was confirmed to be the result of a metastatic true malignant mixed tumor by using CT-guided biopsy. The current case demonstrated an extremely rare example of atypical pulmonary metastases from a true malignant mixed tumor of the parotid gland showing an air-space pattern and calcification.

Malignant mixed tumor in the salivary gland of a cat

The presence of a malignant mixed tumor, also known as a carcinosarcoma, in the salivary gland is very rare. Such mors, which are typically aggressive, are characterized by the presence of carcinomatous and sarcomatous components. 9-year-old neutered female domestic short-haired cat presented with swelling in the right mandibular lesion that had rapidly enlarged over the previous 3 weeks. Physical examination revealed a large, fluctuated and painless subcutaneous swelling that was associated with a firm mass. Radiographs of the head revealed a soft-tissue density that involved faint circular calcific opacity. Contrast-enhanced computed tomography revealed that the peripheral capsulated cystic area had a contrast enhanced region without bone lysis. The cat received a total excision of the mass and postoperative radiotherapy. Histopathological analysis of the mass revealed that it was a malignant mixed tumor. Metastasis to the lung was discovered 7 weeks later, at which time treatment was stopped.

Siringoma condróide maligno: relato de caso e revisão da literatura / Malignant chondroid syringoma: case report and literature review

O siringoma condróide maligno, também designado tumor misto maligno da pele, é lesão extremamente rara com aproximadamente 40 casos descritos até o presente momento. Trata-se de neoplasia derivada das glândulas sudoríparas que acomete preferencialmente tronco e extremidades distais em pacientes na sexta década e predomina no sexo feminino. Relatamos um caso com os aspectos clínicos e histológicos característicos para familiarizar o patologista com esse diagnóstico, visto que essa neoplasia com freqüência apresenta metástases locais e/ou regionais (cerca de 60 por cento), sobretudo para linfonodos, pulmões e ossos; além disso, possui taxa de mortalidade de aproximadamente 25 por cento após curso evolutivo prolongado.

Malignant chondroid syringoma (malignant mixed tumor of the skin) is an extremely rare tumor. Approximately 40 cases have been described to date. It is a neoplasm originated from sweat gland. The tumor predominantly affects the trunk and distal extremities, arises in the sixth decade and shows a predilection for females. We relate one case with clinical and histopathologic typical features to alert the pathologist to this diagnosis, since this neoplasm has a metastasic rate of approximately 60 percent (lymph nodes, lungs and bones are predominantly affected) and a mortality of roughly 25 percent.

A Case of Salivary Duct Carcinoma Ex Pleomorphic Adenoma of Parotid Gland / 대한이비인후과학회지

Carcinoma ex pleomorphic adenoma of the salivary gland is a relatively uncommon tumor that accounts for roughly 4% of all malignancies at this location. The lesion occurs when a malignant tumor arises in the epithelial component of a pleomorphic adenoma. It usually arises in the parotid gland. Typically, it is a high grade carcinoma, frequently leading to metastasis and disease-related death. We experienced a case of a salivary duct carcinoma that arose in the epithelial component of a pleomorphic adenoma in the parotid gland with neck metastasis. After total parotidectomy and modified radical neck dissection, he was given 10, 980 cGy of radiation postoperatively for 7 weeks. The clinicopathologic feature of this tumor are presented with a review of literatures.

A Case of Carcinosarcoma in Submandibular Gland / 대한이비인후과학회지

Carcinosarcomas of the salivary gland are very rare and demonstrate malignant epithelial and sarcomatous components. Patients of this tumor are usually in their sixties and it most frequently involves the parotid (65%). Carcinosarcomas are considered by most investigators to be aggressive neoplasms with poor survival. We report a case of submandibular gland carcinosarcoma that showed squamous cell carcinoma and fibrosarcoma in a 27-year-old man.

Carcinoma ex mixed tumor arising in the parotid gland / 대한구강악안면방사선학회지

Carcinoma exmixed tumor is a mixed tumor in which a second neoplasm develops from the epithelial component that fulfills the criteria for malignancy. This tumor occurs frequently in the parotid glands. Individuals in whom carcinoma ex mixed tumor have a past history of benign mixed tumor. These lesions contain both a benign mixed tumor as well as a malignant neoplasm. We report a case of carcinoma ex mixed tumor which occurred in the parotid gland. A 67-year-old woman presented with movable right mass. she complained pain and facial paralysis. The clinical presentation, several diagnostic images, and histopathologic findings are presented.

Carcinosarcoma Arising from Mixed Tumor of the Parotid Gland: A case report

A case of true malignant mixed tumor of the parotid gland is reported. The tumor, occuring in a 55-year-old man, started to grow rapidly after a long history of parotid mass. Total parotidectomy was carried out and the resected tumor measured 5x4x3 cm with a cut surface showing grayish-white solid and myxoid appearance. Microscopically, the tumor had both carcinomatous and sarcomatous elements, the former consisting of undifferentiated carcinoma with focal areas of ductal differentiation and the latter consisting of pleomorphic sarcoma with chondrosarcomatous differentiation. A remnant of benign pleomorphic adenoma could also be identified. Immunohistochemical study demonstrated focal cytokeratin reactivity in the carcinoma cells and vimentin in sarcomatous elements. It is assumed from these clinical and histological findings that the tumor had transformed from a pre-existing benign pleomorphic adenoma.