Bladder carcinosarcomas: three cases with diverse histogenesis

Abstract

Carcinosarcomas of the bladder are rare. We describe three such tumours, including an apparently unique case in which the components comprised liposarcoma and poorly-differentiated transitional cell elements. A second example included chondrosarcomatous elements. These two tumours showed architectural and immunocytochemical features which suggested that they had originated as carcinomas but had subsequently differentiated along both epithelial and mesenchymal pathways. The third tumour contained both carcinoma and osteosarcoma and may represent a collision tumour.

Modulations of the epithelial phenotype during embryogenesis and cancer progression

“…In humans, these infrequent tumors can appear in different organs, including digestive tract [47][48][49], lung [50][51][52][53][54][55], bladder [56][57][58][59][60], uterus [61,62] prostate [63][64][65], or breast [66][67][68][69][70][71]. They consist of a mixture of epithelial as well as mesenchymal cancer cells.…”

Immunohistomorphologic and molecular cytogenetic analysis of a carcinosarcoma of the urinary bladder

“…The multiclonal hypothesis, proposing that the tumor originates from different stem cells, resulting in a composite tumor ii. The monoclonal hypothesis, proposing that the tumor originates from a single pluripotential stem cell with an extremely divergent differentiation during tumor progression [4] Cytogenetic studies may help to evaluate both hypotheses. In a single experiment, comparative genomic hybridization (CGH) can provide an overview regarding gains and losses of chromosomal material in a tumor cell population.…”

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component

“…15 The monoclonal theory (divergence hypothesis) proposes that both carcinomatous and sarcomatous elements are derived from a single pluripotent stem cell that subsequently diverges along separate epithelial and mesenchymal pathways. 4,16 Findings from several studies lend support to the divergence hypothesis. [17][18][19][20] For example, studies examining loss of heterozygosity in patients with CS of the bladder found identical patterns between the epithelial and sarcomatoid components of the tumors, [18][19][20] although identical patterns were more frequent in genetic alterations related to early events in bladder carcinogenesis rather than those associated with later events.…”