Cases reported "Carcinosarcoma"

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1/17. Sarcomatoid carcinoma of the renal pelvis: a case report.

    A case of sarcomatoid carcinoma of the renal pelvis is reported. A 72-year-old male was admitted with a chief complaint of right flank pain. Clinical imaging studies revealed marked dilation of the right renal pelvis caused by a tumor at the pyeloureteric region. Right nephrectomy was performed in June 1999. The 8.4 x 6.5 cm tumor was grossly polypoid in appearance and protruded into the renal pelvis. Histologically, sarcomatoid spindle cells predominated over the carcinomatous component (mainly transitional cell carcinoma, partly associated with squamous cell and adenocarcinoma components). Osteoclast-like CD68-positive multinucleated giant cells were scattered. The sarcomatoid component was immunoreactive for both cytokeratin and vimentin. Sarcomatoid cells negative for cytokeratin were also noted. In both the sarcomatoid and carcinomatous components, nuclear overexpression of p53 oncoprotein was confirmed. The histogenesis of sarcomatoid carcinoma of the renal pelvis is discussed.
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2/17. Unusual retrovesical masses in men.

    Retrovesical masses in men not related to prostatic carcinoma or hyperplasia is an uncommon pathology. Rare masses or unusual manifestations of those common diseases are a diagnostic dilemma. We review our experience in three unusual retrovesical masses in men: carcinosarcoma filling a giant bladder diverticulum; cystic prostatic carcinoma; and acquired cystic dilatation of the seminal vesicle associated with a prostatic carcinoma that obstructed and invaded the vesicle. We report the imaging findings and review the literature. In our experience, the imaging findings are usually not specific for doing a precise diagnosis and biopsy procedures are necessary.
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3/17. Uterine carcinosarcoma with melanocytic differentiation.

    A 65-year-old black woman was found to have a 3.0 cm endometrial tumor that was a carcinosarcoma with a major epithelial and a less prominent mesenchymal component. The latter was undifferentiated but one focus of chondroid differentiation was noted. The former showed papillary serous differentiation. Melanin pigment was observed in both epithelial and mesenchymal components. Staining with antisera to S100 protein and HMB-45 confirmed the presence of melanocytes. An endocervical focus of tumor also contained melanin. Electron-microscopic studies showed large tumor cells with an irregularly indented nucleus and abnormal giant cytoplasmic melanosomes. Only one case of uterine carcinosarcoma with melanocytic differentiation has been previously reported.
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4/17. Hepatocellular carcinoma with osteoclast-like giant cells: possibility of osteoclastogenesis by hepatocyte-derived cells.

    Giant cell tumor (GCT) of bone is a primary osteolytic tumor that is characterized by the formation of osteoclast-like giant cells. In addition to GCT of bone, extraskeletal GCT are known to be formed in several soft tissues. Giant cells in GCT of bone were suggested to be identical to osteoclasts, but the characterization of giant cells in extraskeletal GCT remains incomplete. In this study, a case of sarcomatoid hepatocellular carcinoma with osteoclast-like giant cells was analyzed. immunohistochemistry revealed the expression of almost all markers of osteoclasts: tartrate-resistant acid phosphatase, CD68, CD51, CD54 and matrix metalloprotease-9, in osteoclast-like giant cells in the tumor. in situ hybridization revealed the expression of receptor activator of nuclear factor-kappa b (RANK) in the giant cells and receptor activator of nuclear factor-kappa b ligand (RANKL) in the tumor cells. The hepatic origin of the sarcomatoid hepatocellular carcinoma cells was confirmed by the expression of albumin. This is the first report suggesting that hepatocyte-derived cells possess the potential for osteoclastogenesis. In addition, these findings suggest that osteoclast-like cells in the hepatocellular carcinoma were formed by the same mechanism as osteoclastogenesis in bone.
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5/17. carcinosarcoma of the submandibular salivary gland. Immunohistochemical findings.

    Carcinosarcomas of the salivary glands are rare lesions that generally have been associated with benign mixed tumors. The authors report a case of a submandibular gland lesion, which occurred in a 64-year-old man, that was composed of intermingled ductal type adenocarcinoma and osteogenic sarcoma with a large component of osteoclast-like giant cells. The local recurrence of the tumor was entirely sarcomatous with no epithelial component observed. There was no histologic evidence of a preexisting or coexisting pleomorphic adenoma. Immunohistochemical studies confirmed two separate populations of tumor cells, corresponding to the histologic growth pattern. The authors review the literature and discuss histogenetic implications of distinction between de novo carcinosarcoma and carcinosarcoma in association with pleomorphic adenoma.
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6/17. Palliative removal of a giant polypoid 'carcinosarcoma' of the oesophagus by YAG laser photocoagulation of the tumour stalk.

    Dysphagia in a 79 year old lady was caused by a giant polypoid tumour in mid-oesophagus. Surgery was not appropriate. Shrinkage of the tumour and its eventual detachment were achieved by stopping its blood supply by YAG laser photocoagulation of the tumour stalk. Good, temporary palliation of the dysphagia was achieved.
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7/17. Sarcomatoid carcinoma of common bile duct: a case report.

    Sarcomatoid carcinomas (carcinosarcomas) are rare lesions in the hepatobiliary pancreatic system. We present an extremely rare case of sarcomatoid carcinoma of the common bile duct. The tumor showed a biphasic pattern of intermixed carcinomatous (adenocarcinoma) and sarcomatoid elements (spindle and giant cells). By immunohistochemical staining, cytokeratin and vimentin were demonstrated in the sarcomatoid component. The proliferative activity and the oncoproteins expressed by the tumor were investigated by the PCNA, Ki-67, p53 and Bcl-2 in different tumor fields. overall, the intensities of PCNA and p53 were moderate in the sarcomatoid component, but mild in the carcinomatous component. However, Ki-67 and Bcl-2 were both negative in the carcinomatous and sarcomatoid components. The possible histogenensis of sarcomatoid carcinoma of the common bile duct is discussed. We report upon an additional extremely rare case of sarcomatoid carcinoma arising in the common bile duct together with its immunohistochemical characteristics, and give details of its proliferative activity and oncoprotein expression.
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8/17. Sarcomatoid carcinoma of the renal pelvis with giant cell tumor-like features: case report with immunohistochemical findings.

    Sarcomatoid transitional cell carcinoma is a rare entity, in which a malignant, overtly epithelial component coexists with areas having a sarcoma-like appearance. Histological distinction of sarcomatoid carcinomas from carcinosarcomas is often difficult and immunohistochemistry is a helpful diagnostic adjunct in the correct diagnosis. In the present report, we describe an uncommon case of sarcomatoid transitional cell carcinoma of the renal pelvis, associated with giant cell tumor-like features. Immunoperoxidase staining for cytokeratin was positive in spindle cell component, indicating an epithelial origin. The carcinomatous component showed a diffuse membranous reactivity for E-cadherin, whereas the reactivity was sporadic and weaker in the sarcomatoid component, suggesting that the decrease of E-cadherin expression might be associated with the acquisition of sarcomatous morphology. Osteoclast-like multinucleated giant cells were positive for CD68 and negative for p53 oncoprotein, suggesting that they represent a non-neoplastic component that is reactively induced in the tumor stroma.
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9/17. Endometrial carcinosarcoma with osteoclast-like giant cells.

    We encountered a case of endometrial cancer with a poorly differentiated epithelial component, accompanied by a compact proliferation of atypical spindle cells and osteoclast-like giant cells. Immunohistochemically, the epithelial component was EMA and prekeratin positive with vimentin-positive spindle cells, whereas the osteoclast-like giant cells were strongly immunoreactive for CD68. The description of osteoclast-like giant cells adds to the knowledge of endometrial carcinosarcoma tumor biology.
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10/17. Sarcomatoid basal cell carcinoma--predilection for osteosarcomatous differentiation: a series of 11 cases.

    Primary cutaneous carcinomas rarely show heterologous malignant mesenchymal differentiation. We report 11 cases of sarcomatoid basal cell carcinoma (BCC) with osteosarcomatous differentiation. The patients (7 men and 4 women) ranged in age from 61 to 92 years (median 75 y). The tumors presented as exophytic nodules (0.3 to 7 cm) on the head (n=6), upper limb (n=3), and lower limb (n=2). All lesions were completely excised. Seven patients were alive without evidence of disease (follow-up interval 5 to 24 mo) and 1 patient died of unrelated causes at 7 months without evidence of disease. On histology, the tumors were dermal in location with 2 cases showing focal subcutaneous involvement. Ten tumors were well-circumscribed and 1 tumor showed focally infiltrative edges. Ten tumors revealed conventional BCC associated with varying proportions of osteosarcomatous and undifferentiated sarcomatous stroma. Transition from neoplastic epithelial to mesenchymal cells was seen in 8 cases. One case showed a purely osteoclastic giant cell rich malignant mesenchyme, interpreted as representing early stages of osteosarcomatous transformation. Previously unreported in sarcomatoid BCC, the mesenchymal component of another two cases displayed predominant malignant giant cell tumor like areas and 1 further case disclosed areas reminiscent of telangiectatic osteosarcoma. Pancytokeratins (AE1/3 and MNF116) and smooth muscle actin stained occasional undifferentiated sarcomatous cells in 2 and 3 tumors, respectively. MNF116 and EMA were focally positive in osteosarcomatous tumor cells of 1 case. Although the follow-up interval is short, our data suggest an excellent prognosis for polypoid and exophytic sarcomatoid BCC after complete surgical resection.
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