A Rare Cutaneous Malignancy: A Primary Cutaneous Carcinosarcoma with Adnexal Epithelial Component (Trichoblastic Carcinosarcoma) of Left Temporal Region

Abstract

Primary cutaneous carcinosarcoma (PCCS) is a rare cutaneous biphasic tumour with just 120 cases being reported till date. The epithelial component trichoblastic carcinoma/ malignant trichoblastoma (trichoblastic carcinosarcoma) is even rarer, so is the present case. An eighty years old male patient presented with a rapidly progressing ulceroproliferative nodular growth on the left temporal region. The incisional biopsy showed primary cutaneous carcinomasarcoma (PCCS). IHC showed epithelial and stromal component marked exclusively for pancytokeratin (AE1/AE3) CK5&6/ p40 and vimentin respectively. Both components were immunopositive for D2-40 and immunonegative for BerEP4/ S100/ Melan A/ MITF, thus final diagnosis given was Trichoblastic carcinosarcoma. Wide excision of the lesion with local rotation flap and skin grafting (thigh skin) was done. Patient remains disease free after four years also. Present case thus highlights the importance of HPE, IHC and early surgery for excellent prognosis of PCCS.

The Rarity in the Rarity: Presentation of Three Cases of Cutaneous Carcinosarcoma with Clinical and Histopathological Insights

“…A cCS is a rare and aggressive malignant biphasic tumor, of which approximately 120 cases have been reported in the literature up to the beginning of 2024 [ 10 ]. Although rare, the growing number of reported cases has allowed us to add some knowledge to a poorly characterized entity, both from a clinical, histological, and molecular point of view [ 9 , 10 ].…”

“…A cCS is a rare and aggressive malignant biphasic tumor, of which approximately 120 cases have been reported in the literature up to the beginning of 2024 [ 10 ]. Although rare, the growing number of reported cases has allowed us to add some knowledge to a poorly characterized entity, both from a clinical, histological, and molecular point of view [ 9 , 10 ]. It is important to underscore that there are different names to define it, such as metaplastic carcinoma, sarcomatous carcinoma, pseudosarcoma, and biphasic sarcomatoid carcinoma, reflecting the important and unresolved debate regarding this histogenesis [ 11 , 12 ].…”