Carcinosarcoma of the Mediastinum: A Rare Cause of Vocal Cord Palsy and Progressive Dysphagia

Abstract

Carcinosarcoma is a rare type of malignant tumour that possess both the elements of carcinoma and sarcoma. They may occur in various locations such as the uterus, breast, thyroid, lung and gastrointestinal system. However, very few primary mediastinal carcinosarcomas have been reported. We are presenting a case of a 75-year-old male who presented with progressive dysphagia and hoarseness for 3 weeks. Contrast-enhanced computed tomography of the neck showed features of enlarged mediastinal necrotic nodes and the biopsy of this mass showed morphology and immunohistochemical profile that are consistent with carcinosarcoma. However, the patient succumbed to his illness soon after diagnosis.

A Case of Mediastinal Carcinosarcoma With Beta-HCG Production and KRAS Mutation

“…1 There is significant morphological overlap between sarcomatoid carcinoma and carcinosarcoma and therefore, the presence of malignant heterologous component is required for the diagnosis of carcinosarcoma. 1 To the best of our knowledge, only rare cases sharing some of the clinicopathological features with our case have been documented in the English language literature within the last 3 decades [3][4][5][6][7][8] (summarized in Table 1). Some of the prior tumors reported as carcinosarcoma would have been now classified as sarcomatoid carcinoma.…”

“…Some of the prior tumors reported as carcinosarcoma would have been now classified as sarcomatoid carcinoma. [3][4][5][6] As a group these tumors appear to affect both sexes from 5th to 9th decades of life. The presenting symptoms are not specific and include chest pain and dyspnea.…”

“…2 Only rare carcinosarcoma have been documented in the mediastinum. [3][4][5][6][7][8] In the mediastinum, the tumor is presumed to originate from the thymus, or from the lung with invasive spread into mediastinum. Here we provide a detailed clinicopathological description of carcinosarcoma presenting within the mediastinum and showing unusual paraneoplastic and genetic profiles.…”