ABSTRACT
ABSTRACT Introduction Carcinosarcoma of the bladder is a very rare neoplasm. The pathogenesis of carcinosarcomas is not clearly understood and remains a subject of debate. Whilst there is some research conceptualizing the histopathological findings of bladder carcinosarcomas, the demographic features, clinical outcomes, prognosis and treatment options remain unclear. Materials and Methods We analyzed 12 consecutive cases of patients with sarcoma-toid bladder cancer who were treated surgically at a single Urology Department be-tween 1999 and 2015. Radiology, pathology and surgical reports were reviewed to determine the pathological staging at the time of cystectomy. These were directly compared with 230 patients having cystectomies for urothelial cell carcinoma. The sarcomatoid patients, were compared to patients with urothelial cell cancers. The other histological sub types, squamous cell (17), neuroendocrine (9), metastatic (7), mixed (4), adenocarcinoma (3), were not included. Results and conclusion Carcinosarcoma of the urinary bladder is often described in the literature as a highly malignant neoplasm that is rapidly lethal. We found that the sarcoma does not offer a worse prognosis than conventional high-grade urothelial car-cinoma. There is no significant difference in grade, stage, positive surgical margin rate, nodal involvement, associated prostate cancer or incidence rates of progression, all cause or disease specific mortality. There was a barely significant difference in carcinoma in-situ. However, carcinosarcomas are three times the volume of urothelial cell tumors which may contribute to its reputation as an aggressive tumour (44cc v 14cc). Sarcomatous elements do not appear, from our small study, to bestow a worse prognosis.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urinary Bladder Neoplasms/surgery , Carcinosarcoma/surgery , Prognosis , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/pathology , Carcinoma, Transitional Cell/surgery , Carcinosarcoma/mortality , Carcinosarcoma/pathology , Cystectomy , Survival Analysis , Retrospective Studies , Treatment Outcome , Middle AgedABSTRACT
El carcinosarcoma de laringe es un tumor bifásico raro que representa menos del 1% de todos los tumores malignos de laringe. Debido a su doble naturaleza epitelial y mesenquimal esta neoplasia ha sido denominada de distintas maneras en la literatura, siendo indispensable el estudio mediante inmunohistoquímica para establecer un diagnóstico correcto. Se presentan 2 casos de carcinosarcoma de laringe, confirmados mediante estudio con inmunohistoquímica, ambos tratados mediante laringectomía total. Se elabora una discusión de los principales aspectos clínicos, histopatológicos y terapéuticos de esta infrecuente neoplasia.
The larynx carcinosarcoma is a rare biphasic tumor that represents less than 1% of all malignant tumors of the larynx. Because of its biphasic epithelial and mesenchymal nature this neoplasm has been called in different ways in the literature being indispensable the study by immunohistochemistry to establish a proper diagnosis. We present 2 cases of larynx carcinosarcoma confirmed by immunohistochemical study, both treated with total laryngectomy. A discussion of the main clinical, histopathological and therapeutic aspects of this rare neoplasm is made.
Subject(s)
Humans , Male , Middle Aged , Aged, 80 and over , Carcinosarcoma/surgery , Carcinosarcoma/pathology , Laryngeal Neoplasms/surgery , Laryngeal Neoplasms/pathology , Laryngectomy/methods , Carcinosarcoma/diagnostic imaging , Laryngeal Neoplasms/diagnostic imagingABSTRACT
Introdução: Os carcinossarcomas uterinos são neoplasias infrequentes, correspondendo a apenas 3-9 por cento de todas as neoplasias ginecológicas, representam 48 por cento de todos os sarcomas, e possuem incidência de 8,2 por 1 milhão mulheres/ano. As principais manifestações clínicas são o sangramento vaginal anormal em idade pós-menopausa e dor abdominal. Caracterizam-se morfologicamente por elementos epiteliais e estromais. Podem eventualmente invadir estruturas adjacentes, inclusive a bexiga urinária. Relato do caso: Apresentamos um caso de carcinossarcoma uterino com invasão de bexiga mimetizando mullerianose com transformação maligna. A paciente do sexo feminino de 69 anos apresentava hematuria macroscópica como queixa única. Durante a investigação diagnóstica, após cistoscopia com exame anatomopatológico, foi sugerida a hipótese de mullerianose com transformação benigna. A paciente foientão encaminhada para ressecção cirúrgica da neoplasia. Durante o procedimento cirúrgico, notou-se a existência deuma massa tumoral uterina que invadia a bexiga urinária, e, após análise anatomopatológica, mostrou tratar-se de umcarcinossarcoma uterino com invasão vesical. Conclusão: Manifestações incomuns em doenças com grande potencialde malignidade, além de retardar o processo diagnóstico, interferem diretamente no prognóstico do paciente.
Subject(s)
Humans , Female , Aged , Carcinosarcoma/surgery , Carcinosarcoma/diagnosis , Carcinosarcoma/pathology , Uterine Neoplasms/surgery , Uterine Neoplasms/diagnosis , Uterine Neoplasms/pathology , Mixed Tumor, Mullerian/surgery , Mixed Tumor, Mullerian/diagnosis , Mixed Tumor, Mullerian/pathology , Neoplasm Invasiveness , Urinary BladderABSTRACT
Gallbladder Carcinosarcoma corresponds to less than 1 percent of all malignant tumors of the gallbladder. We report an 82 years old female subjected to an open cholecystectomy with the preoperative diagnosis of acute cholecystitis. The pathological study of the surgical piece showed a malignant tumor with epithelial (carcinoma) and stromal (sarcoma) components. A postoperative CAT scan showed multiple nodular lesions in the peritoneum and omentum. The patient died eight months after the operation.
El carcinosarcoma de la vesícula biliar (CSVB) es una neoplasia maligna con diferenciación bifásica (epitelial y estromal) y que representa menos del 1 por ciento de todas las neoplasias malignas de la vesícula biliar. Presentamos el caso de una mujer de 82 años sometida a una colecistectomía abierta de urgencia en Septiembre de 2007 con diagnóstico de colecistitis aguda. El examen histológico de la pieza operatoria describe una lesión neoplásica maligna compuesta por una mezcla de componente epitelial (carcinoma) y estromal (sarcoma), este último con extensas áreas de diferenciación heteróloga de tipo condroide. Estos tumores presentan un comportamiento agresivo con rápida diseminación local y recurrencia siendo generalmente difícil la realización de cirugías con intención curativa (R0), condiciones que explican el pobre pronóstico asociado al CSVB.
Subject(s)
Humans , Female , Aged, 80 and over , Cholecystectomy , Carcinosarcoma/surgery , Carcinosarcoma/pathology , Gallbladder Neoplasms/surgery , Gallbladder Neoplasms/pathology , Cholecystitis , Fatal OutcomeABSTRACT
El carcinosarcoma es un tumor poco frecuente, bifásico, que ha sido comunicado en diferentes sitios del organismo. Está compuesto por un componente maligno epitelial íntimamente asociado con un componente epitelial sarcomatoide que puede ser homólogo y heterólogo. Existen carcinosarcomas cutáneos y extracutáneos. Los carcinosarcomas extracutáneos muestran un pronóstico pobre. Presentamos un paciente de 75 años, fototipo II, que consulta por presentar un tumor exofítico angiomatoide sangrante de 8 mm, de aspecto botriomicoide, de 2 meses de evolución en piel frontal derecha. Se confirma con biopsia y técnicas de inmunohistoquímica la existencia de 2 morfologías celulares típicas del carcinosarcoma. El tumor fue extirpado con un centímetro de margen de seguridad. El paciente, al año de su intervención, está libre de recurrencias y metástasis. El componente sarcomatoso del tumor es comprendido como una transformación metaplásica del componente carcinomatoso. Estos tumores son potencialmente agresivos.
Carcinosarcoma is an uncommon biphasic neoplasm that has been reported in diverseanatomical sites. This tumor is composed of two malignant epithelial components: onetypical and the other atypical, this one resembling mesenchymal tissue. Both are intimatelyassociated .The latter may be homologous or heterologous. When these tumors are locatedat extracutaneous sites, they are characteristically aggressive.We report a 75-year-old man who developed a solitary reddish bleeding nodule that quicklygrew in a two-months period. It resembled a pyogenic granuloma and was located on hisright frontal skin. Clinical, histologycal and immunohistochemical features were evaluated.The tumor was completely excised with a one-centimeter safety margin, and after a lapse ofone year he is free of local relapses or metastases.The sarcomatous component of the tumor is considered to be a metaplastic transformation ofthe carcinomatous component. These tumors are potentially aggressive if partially removed,thus complete excision is mandatory.
Subject(s)
Humans , Aged , Carcinosarcoma/surgery , Carcinosarcoma/diagnosis , Carcinosarcoma/pathology , Skin Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Diagnosis, DifferentialABSTRACT
Primary adrenal sarcomatoid carcinoma is rare malignant tumor with the characteristics of carcinoma and sarcoma. To date, only one case of primary sarcomatoid carcinoma in the adrenal gland was reported. We present here computed tomography appearance and pathological features of the case with primary adrenal sarcomatoid carcinoma confirmed by pathology. In addition, a brief review of the relevant literature is presented.
Subject(s)
Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/diagnostic imaging , Adrenal Gland Neoplasms/surgery , Adrenalectomy/methods , Aged , Biopsy, Needle , Carcinosarcoma/pathology , Carcinosarcoma/diagnostic imaging , Carcinosarcoma/surgery , Contrast Media/diagnosis , Follow-Up Studies , Humans , Immunohistochemistry , Male , Multidetector Computed Tomography/methods , Neoplasm Staging , Radiographic Image Enhancement , Rare Diseases , Treatment OutcomeABSTRACT
Carcinosarcoma of the urinary bladder is a very rare neoplasm accounting for less than 0, 05%of urothelial tumours is a biphasic malignant neoplasm with only 79 cases reported in the English literature. Histologicaly, it exhibits morphologic and/or immunohitochemical evidence of epithelial and mesenchymal differenciation with the presence or absence of heterologous elements. It usually involves aged adults after 60 years and it has a poor prognosis. We report three cases with an emphasis on unusual histologic features. Three male patients age 76 to 86 years were found to have polypoide masses in the urinary bladder. In all cases, microscopic examination revealed biphasic neoplasms with distinct mesenchymal and epithelial components. The two first cases were remarkable respectively by the presence of chondrosarcomasrcomatous and osteosracomatous components
Subject(s)
Humans , Male , Carcinosarcoma/surgery , Urinary Bladder Neoplasms/pathology , Urothelium/pathology , Fatal Outcome , Treatment OutcomeABSTRACT
Lesões malignas do esôfago, excluindo-se carcinomas escamocelulares e adenocarcinomas, são bastante incomuns. Os autores relatam um caso de carcinoma de células fusiformes de esôfago. É um tumor maligno raro caracterizado por volumosa massa lobulada no terço médio do esôfago, que causa relativamente pequena obstrução apesar do seu volume. Em seguida é apresentada revisão da literatura sobre o assunto
Malignant lesions of the esophagus, other than epidermoids and adenocarcinomas, are remarkably uncommon. The authors report a case of a patient with a spindle cell carcinoma of the esophagus. This is a rare malignant tumor characterized by a large bulky lobulated mass in the middle third of the esophagus that causes relatively little obstruction in spite of its volume. A review of literature is presented.
Subject(s)
Humans , Male , Adult , Carcinosarcoma/surgery , Carcinosarcoma , Esophageal Neoplasms , Esophagus/physiopathology , Sarcoma/surgery , Sarcoma , Endoscopy, Gastrointestinal , Tomography, X-Ray ComputedABSTRACT
Se presenta el reporte de un caso de carcinosarcoma de la mama como entidad clinicopatológica poco frecuente dentro de la patología maligna de la mama. Igualmente se hace una revisión bibliográfica
Subject(s)
Adult , Humans , Female , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Breast/pathology , Carcinosarcoma/diagnosis , Carcinosarcoma/pathology , Carcinosarcoma/surgeryABSTRACT
Säo apresentadas as manifestaçöes clínicas e endoscópicas de um caso de carcinossarcoma de esôfago. O esofagograma e a endoscopia revelaram massa polipóide no esôfago médio. O tumor era grande, pediculado, coberto por mucosa lisa, com algumas erosöes. Histopatologicamente, o tumor era composto por uma mistura de invasäo de células queratinizadas e faixas de células arredondadas, lembrando fibrossarcoma. O tumor foi retirado cirurgicamente e näo foi encontrada infiltraçäo de submucosa. Näo foram detectadas metástases à distância ou recidiva local durante 12 meses de seguimento. O diagnóstico inicial foi feito através da realizaçäo de polipectomia endoscópica parcial. Os autores concluem que a polipectomia parcial pode ser valiosa no diagnóstico pré-operatório de massas polipóides e esôfago
Subject(s)
Humans , Male , Middle Aged , Carcinosarcoma/diagnosis , Esophageal Neoplasms/diagnosis , Polyps/diagnosis , Carcinosarcoma/pathology , Carcinosarcoma/surgery , Esophagoplasty , Esophagoscopy , Esophageal Neoplasms/surgery , Esophageal Neoplasms/pathology , Polyps/surgery , Polyps/pathologyABSTRACT
Os autores apresentam um caso de tumor mülleriano misto maligno do útero, diagnosticado em paciente diabética, com 66 anos de idade, e que apresentou sangramento uterino pós-menopausa. Trata-se de tumor maligno raro, que incide principalmente em mulheres após a menopausa. Os aspectos clínicos, diagnóstico, tratamento e prognóstico säo descritos a seguir.
Subject(s)
Humans , Female , Aged , Carcinosarcoma/diagnosis , Mixed Tumor, Mullerian/diagnosis , Uterine Neoplasms/diagnosis , Carcinosarcoma/complications , Carcinosarcoma/surgery , Diabetes Mellitus/complications , Mixed Tumor, Mullerian/surgery , Mixed Tumor, Mullerian/complications , Uterine Neoplasms/complications , Uterine Neoplasms/surgeryABSTRACT
Se presenta un caso de blastoma pulmonar del L.S.D. Se hallaron 22 casos en la literatura extranjera y ninguno en la nacional. Fue tratado con cirugía únicamente, realizándose resección y reimplante bronquial. Se discute su diferencia con el carcinosarcoma