Cases reported "Carcinosarcoma"

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1/49. Esophageal sarcomas: report of three cases.

    BACKGROUND/AIMS: Sarcomas of the esophagus, including carcinosarcoma, are rare neoplasms. methods: The clinical and pathologic characteristics of 3 patients with esophageal sarcomas are presented, including the only recorded esophageal carcinosarcoma and 2 patients with leiomyosarcoma. RESULTS: All 3 patients were males who presented with dysphagia or an abnormal shadow of the mediastinum on a plain chest X-ray. Two tumors were in the middle esophagus, and the remaining one was in the distal esophagus. On endoscopic examination, all three tumors were noted to be polypoid. These patients underwent surgical excision. One patient died 7 days following the operation, and the remaining 2 patients died of liver metastasis 10 and 22 months following the treatment. CONCLUSION: esophagectomy or esophagogastrectomy is a surgical choice. Even if metastases are present, a palliative resection can still be performed.
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2/49. Rapid-growing carcinosarcoma of the esophagus arising from intraepithelial squamous cell carcinoma: report of a case.

    A case of carcinosarcoma arising from the intraepithelial spreading area of esophageal squamous cell carcinoma (SCC) is reported herein. A 64-year-old man was referred to our hospital for investigation of a sore throat and dysphagia. An endoscopic examination revealed a 2. 5-cm polypoid mass in the mid-esophagus. Esophagograms taken 1 month prior to consultation by our hospital and just before surgery revealed marked change within a period of less than 2 months from a 2-cm sessile elevated mass to a 4-cm polypoid mass with a lobular appearance. The resected specimen contained two lesions in the esophagus. The larger one measured 4.0 x 2.0 x 2.0 cm and had a pedunculated polypoid shape, while the smaller one, measuring 1 cm in diameter, was a plateau-type elevated lesion located 3 cm distal from the larger mass. Histologically, the distal smaller lesion was diagnosed as primary SCC associated with a high frequency of intraepithelial spread, while the larger polypoid mass was composed of spindle-shaped sarcomatous cells, arising from the intraepithelial spread of SCC. To our knowledge, this is the only reported case of esophageal carcinosarcoma arising from an area of intraepithelial spread of SCC that showed such surprisingly rapid growth.
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3/49. A case of esophageal sarcomatoid carcinoma with molecular evidence of a monoclonal origin.

    A case of polypoid tumor of the esophagus consisting of a sarcomatous tumor partly covered with superficial squamous cell carcinoma is described. The sarcomatous component consisted of anaplastic spindle and pleomorphic tumor cells that mimicked malignant fibrous histiocytoma (MFH). Both the sarcomatous and carcinomatous components were positive for p53 immunohistochemically. Further molecular analysis revealed that the two components had the same somatic mutation in the p53 gene. These results suggest a monoclonal origin of this biphasic tumor.
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4/49. True carcinosarcoma of the esophagus with osteosarcoma.

    We experienced a case of true carcinosarcoma of the esophagus with osteosarcoma. Computed tomography scan revealed calcification of the tumor. Immunohistochemically, vimentin staining was positive, and osteoid formation was found in the sarcomatous portion. It was clear that the lesion contained osteosarcoma of mesenchymal origin, and thus we diagnosed it as true carcinosarcoma.
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5/49. carcinosarcoma of the esophagus--pattern of recurrence.

    carcinosarcoma of the esophagus is a rare malignant neoplasm, predominantly affecting men in their seventh decade of life. While presenting symptoms and anatomic location of squamous cell and carcinosarcoma of the esophagus are similar, the latter often presents as a large intraluminal polypoid mass on barium esophagram. The more favorable prognosis associated with carcinosarcoma versus other esophageal neoplasms has been attributed to early onset of symptoms, resulting in prompt diagnosis, and a lower propensity for tumor invasion. We report the case of an elderly woman presenting with dysphagia who was initially diagnosed with esophageal leyomyosarcoma. Final tumor pathology showed esophageal carcinosarcoma.
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6/49. Polypoid sarcomas of the esophagus. A rare but potentially curable neoplasm.

    Five patients with polypoid esophageal sarcoma are reported. All had dysphagia similar to that occurring in epithelial carcinoma of the esophagus. The clinical diagnosis of sarcoma was suspected when barium swallow showed a large polypoid lesion. biopsy was often inconclusive concerning the nature of the lesion except to identify it as a neoplastic process. In spite of their large size, the tumors remained superficial within the esophageal wall. Nodal or distant organ metastasis was absent in 4 of the 5 patients. The histology of these tumors suggests that so-called carcinosarcoma is an epithelial carcinoma of the esophagus with varying amounts of spindle cell features and should be considered separately from sarcoma arising from mesenchymal tissue. Unlike carcinoma, esophageal sarcoma has a favorable prognosis following radical resection, and recent advances in esophageal surgery have decreased the mortality and morbidity of esophagectomy.
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7/49. Esophageal carcinosarcoma.

    carcinosarcoma is an uncommon malignancy of the esophagus that presents as a bulky intraluminal polypoid lesion of the esophagus. Histologically, both carcinomatous and sarcomatous components are seen. Because of accelerated intraluminal growth, esophageal carcinosarcoma often presents relatively early. This report describes a 64-year-old man with carcinosarcoma who was successfully treated with an esophagectomy. As in typical squamous cell carcinoma, early detection and treatment by surgical resection are needed to produce significant long-term survival.
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8/49. Sarcomatoid carcinoma of the colon: a case report with literature review.

    Sarcomatoid carcinoma (SC) is a well defined tumor type that may occur in all organs and anatomic sites but most commonly in the head, neck, respiratory tract, breast, and genitourinary tract. It is a biphasic tumor showing both epithelial- and mesenchymal-like differentiation; however, its carcinomatous nature is widely recognized. SC is rare in the gastrointestinal tract. In the esophagus it accounts for less than 5% of all malignancies and approximately only 35 cases have been described in the stomach. Very few cases have been observed in the small intestine, anorectal junction, liver, and pancreas. To our knowledge only eight cases of SC have been reported in the colon. We report a case of primary colonic SC. Both morphological and immunohistochemical analyses are provided along with an evaluation of the unusual clinical history, therapeutic implications, and controversial differential diagnosis.
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9/49. carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations.

    We report a case of carcinosarcoma of the esophagus characterized by ductal and myoepithelial differentiation. A 61-year-old man was operated on for a polypoid tumor of the distal esophagus. Histologically, this tumor was composed of ductal structures and sarcomatous spindle cells surrounding the ducts at the central area of the tumor. The tumor was also composed of squamous cell and basaloid carcinoma in the periphery. Immunohistochemically, a few spindle cells surrounding the ductal structures showed immunopositivity for alpha-smooth muscle actin and S-100 protein. Electron microscopy revealed that the spindle cells had tonofilament and pinocytic vesicles in the cytoplasm, and basal lamina adjacent to the cytoplasmic membrane. Both of the results strongly supported the suggestion that the spindle cells may be myoepithelial cells. Basaloid carcinoma showed a gradual transition to chondrosarcomatous cells producing the matrix, which had both immunopositivities for S-100 protein and cytokeratin. Therefore, chondrosarcomatous cells may be derived from carcinoma cells. The histogenesis of this tumor may be associated with a totipotent stem cell of esophageal mucosa, which has the potential to differentiate into squamous cells, ductal cells or myoepithelial cells.
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10/49. MDM2 and CDK4 expression in carcinosarcoma of the esophagus: comparison with squamous cell carcinoma and review of the literature.

    Certain tumors of the esophagus that display both sarcomatous and carcinomatous features have long been recognized. The nomenclature, classification, and histogenesis remain controversial and the microscopic differential diagnosis from other esophageal malignancies can be challenging, particularly in small biopsies. In this paper, we review the literature of carcinosarcoma and present two cases of esophageal carcinosarcoma, describing their salient histologic, immunohistochemical, and ultrastructural features. Also, we assess the expression of MDM2 and CDK4 in the carcinomatous and sarcomatous compartments of our cases and we compare them with the expression of these oncogenes in selected cases of esophageal squamous cell carcinoma with prominent stromal reaction. In both of our cases, identification of some epithelial ultrastructural and immunohistochemical features in cells of otherwise sarcomatous phenotype lends support to the common epithelial origin of these neoplasms. Moreover, positive staining for MDM2 and CDK4 in our cases with equally strong reactions in both carcinomatous and sarcomatous elements provides evidence of a role for these molecules in the pathogenesis of carcinosarcoma. In contrast, in cases of squamous cell carcinoma with prominent stromal reaction only the epithelial cells stained strongly for MDM2 and CDK4. These differences in the MDM2 and CDK4 immunohistochemical profile between carcinosarcomas and carcinomas of the esophagus may assist in their differential diagnosis.
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