Carcinosarcoma of the Colon: Presentation of a Case

Tomás, Nuria Peris; Lozano, Arturo García; García, Rosario Martínez; Ortega, Gonzalo Garrigós; Abad, Manuel Martínez

doi:10.1016/j.cireng.2011.07.004

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…We identified 50 previously reported cases of CRC with sarcomatoid components in our literature review, nearly always under the moniker of either carcinosarcoma or sarcomatoid carcinoma 4–53 . These are summarized in Supplemental Table 1, Supplemental Digital Content 1, http://links.lww.com/PAS/B738, though most cases were not published in the pathology literature, various clinicopathologic details were not available for most cases, and a few cases were not published in English or were not accessible.…”

Section: Resultsmentioning

confidence: 99%

“…Carcinoma with sarcomatoid components is extremely rare, with ~50 reported cases 4–53 and one National Cancer Database search 54 previously published in the literature, the former exclusively as single-case reports. These publications usually employed the term “carcinosarcoma” or “sarcomatoid carcinoma,” with the specific term “carcinoma with sarcomatoid components” not used in the literature before the 2019 publication of the latest WHO classification.…”

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Colorectal Carcinoma With Sarcomatoid Components

Golconda,

McHugh,

Allende

et al. 2023

American Journal of Surgical Pathology

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Colorectal carcinoma with sarcomatoid components (which includes so-called carcinosarcomas and sarcomatoid carcinomas) is a rare subtype with 50 reported cases in the literature and overlapping criteria with undifferentiated carcinoma. We collected and described 15 cases from 10 men and 5 women, with a mean age of 66 years. Symptoms included abdominal pain and gastrointestinal bleeding. Most tumors presented in the rectosigmoid region, with a mean size of 8.2 cm. The sarcomatoid component, on average, represented 58% of the tumors and took many forms, including spindled (10 cases), anaplastic (9 cases), and rhabdoid (3 cases); one case showed osteoid matrix. Tumor budding was usually high, and tumor-infiltrating lymphocytes were usually low. The sarcomatoid component was keratin-positive in 10 cases. One case showed loss of mismatch repair protein expression, and 2 cases showed SMARCA4 loss (1 also with SMARCA2 loss). Molecular testing identified mutations in KRAS (n=1), NRAS (n=2), BRAF (n=2), APC (n=1), and TP53 (n=1) in a few cases. Tumors often presented at advanced stage, with 11 cases pT4, 9 cases with nodal metastases, and 7 cases with distant metastases. Follow-up was available for 10 cases (median: 2 months), with 2 alive without disease, 3 alive with disease, and 5 dead. Our findings roughly corresponded with those in previously reported cases. Colorectal carcinoma with sarcomatoid components is rare and aggressive, with a poor prognosis for many patients. We suggest that spindled cells, anaplasia, heterologous elements, and/or a component with definable sarcomatous lineage be used to distinguish colorectal carcinoma with sarcomatoid components from undifferentiated carcinoma.

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confidence: 99%

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confidence: 99%

Colorectal Carcinoma With Sarcomatoid Components

Golconda,

McHugh,

Allende

et al. 2023

American Journal of Surgical Pathology

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Sarcomatoid Carcinoma of the Ascending Colon: A Case Report and Literature Review

Naser

Morrissey

2022

Am J Case Rep

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Patient: Female, 77-year-old Final Diagnosis: Sarcomatoid carcinoma Symptoms: Abdominal pain • abdominal distension • fever • nausea Medication: — Clinical Procedure:— Specialty: Surgery Objective: Rare disease Background: Sarcomatoid carcinoma is a rare tumor that can occur in different organs and anatomical locations. Colonic sarcomatoid carcinoma, also known as carcinosarcoma, is an extremely rare tumor, with only 32 cases reported world-wide. The pathogenesis and guidelines for treatment are poorly understood due to the rarity and invasiveness of the disease. Case Report: A 77-year-old woman presented with worsening lower abdominal pain and associated fever after having initially been diagnosed with stump appendicitis and associated phlegmon 3 weeks prior, which was treated with antibiotics. Repeat imaging revealed an extraluminal versus perforated colonic mass with associated phlegmon. The patient’s condition continued to worsen, with development of obstructive-like symptoms, resulting in operative intervention involving a R2 right hemicolectomy, stapled ileo-colostomy, and partial omentectomy. The patient had an uneventful remainder of her hospitalization other than continued lower abdominal pain. After initial discharge, the patient presented to an outside hospital due to continued deterioration of health, with findings of an additional mass, likely secondary to the previous lymphadenopathy. Ultimately, goals of care were discussed, and the decision was made to provide palliative care, and the patient died due to her illness 32 days after the initial procedure. Conclusions: Carcinosarcoma is an extremely rare tumor with scant research guiding treatment guidelines. Current guidelines gathered from previous case reports suggest treating colorectal carcinosarcoma as adenocarcinoma. Additional research and studies are needed to establish appropriate therapeutic guidelines for carcinosarcoma.

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Carcinosarcoma of the Colon: Presentation of a Case

Cited by 2 publications

References 5 publications

Colorectal Carcinoma With Sarcomatoid Components

Colorectal Carcinoma With Sarcomatoid Components

Sarcomatoid Carcinoma of the Ascending Colon: A Case Report and Literature Review

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