Carcinosarcoma of the skin: Immunohistochemical and electron microscopic observations

Izaki, Seiichi; Hirai, Akio; Yoshizawa, Yusuke; Kitamura, Keijiro; Inoue, Tadashi; Hatoko, Mitsuo; Itoyama, Shinji; Inazu, M.

doi:10.1111/j.1600-0560.1993.tb00655.x

Cited by 40 publications

(27 citation statements)

References 9 publications

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“…In most other cutaneous sarcomatoid carcinomas, however, specific lines of mesenchymal differentiation are not identified and the sarcomatous component resembles atypical fibroxanthoma or high-grade pleomorphic sarcoma. 3,6,14,16,18,19,23,26,33,44 We described some histological findings that have not been reported in the previously published cases of cutaneous sarcomatoid carcinomas. Three of our tumors had predominant malignant giant cell tumor-like tumor components.…”

Section: Discussionmentioning

confidence: 45%

Sarcomatoid Basal Cell Carcinoma—Predilection for Osteosarcomatous Differentiation

Menamin

Goh

Poblet

et al. 2006

American Journal of Surgical Pathology

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Primary cutaneous carcinomas rarely show heterologous malignant mesenchymal differentiation. We report 11 cases of sarcomatoid basal cell carcinoma (BCC) with osteosarcomatous differentiation. The patients (7 men and 4 women) ranged in age from 61 to 92 years (median 75 y). The tumors presented as exophytic nodules (0.3 to 7 cm) on the head (n=6), upper limb (n=3), and lower limb (n=2). All lesions were completely excised. Seven patients were alive without evidence of disease (follow-up interval 5 to 24 mo) and 1 patient died of unrelated causes at 7 months without evidence of disease. On histology, the tumors were dermal in location with 2 cases showing focal subcutaneous involvement. Ten tumors were well-circumscribed and 1 tumor showed focally infiltrative edges. Ten tumors revealed conventional BCC associated with varying proportions of osteosarcomatous and undifferentiated sarcomatous stroma. Transition from neoplastic epithelial to mesenchymal cells was seen in 8 cases. One case showed a purely osteoclastic giant cell rich malignant mesenchyme, interpreted as representing early stages of osteosarcomatous transformation. Previously unreported in sarcomatoid BCC, the mesenchymal component of another two cases displayed predominant malignant giant cell tumor like areas and 1 further case disclosed areas reminiscent of telangiectatic osteosarcoma. Pancytokeratins (AE1/3 and MNF116) and smooth muscle actin stained occasional undifferentiated sarcomatous cells in 2 and 3 tumors, respectively. MNF116 and EMA were focally positive in osteosarcomatous tumor cells of 1 case. Although the follow-up interval is short, our data suggest an excellent prognosis for polypoid and exophytic sarcomatoid BCC after complete surgical resection.

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Section: Discussionmentioning

confidence: 45%

Sarcomatoid Basal Cell Carcinoma—Predilection for Osteosarcomatous Differentiation

Menamin

Goh

Poblet

et al. 2006

American Journal of Surgical Pathology

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“…The mesenchymal components were multiple, comprising fibrosarcoma, osteosarcoma, chondrosarcoma, and synovial sarcoma, and the patient developed lung metastases 5 years after diagnosis. Izaki et al 18 It is of note that all the cases reported here had nodular BCC as the epithelial components. This low-risk profile may in part explain the apparent low risk for recurrence and metastasis.…”

Section: Discussionmentioning

confidence: 85%

Basal cell carcinoma with a sarcomatous component (carcinosarcoma): A series of 5 cases and a review of the literature

Rose

Merchant

Stables

et al. 2008

Journal of the American Academy of Dermatology

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“…1,2,6,[8][9][10] The differing theories range from a collision of 2 synchronous, separate tumors; to the combination of 2 divergent cell lines from a single stem cell; to the conversion from carcinoma to carcinosarcoma by metaplastic transformation of part of the carcinoma in to a sarcoma. 1,2,6,[8][9][10] As most of these cases are associated with a basal cell carcinoma or squamous cell carcinoma 2,[8][9][10][11][12] or, less likely, a malignant adnexal tumor, 2,[8][9][10][11] it may be best to refer to such tumors as ''sarcomatoid carcinoma'' rather than as ''carcinosarcoma,'' as they are likely derived from the epithelial tumor. Malignant cutaneous mixed tumors (myoepithelial carcinomas) may be considered a rare variant of carcinosarcoma, which show true biphasic differentiation, as they appear to be derived from pluripotent stem cells, which give rise to both mesenchymal and epithelial cell types.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Carcinosarcoma With Myoepithelial Differentiation: Immunohistochemical and Cytogenetic Analysis of a Case Presenting in an Unusual Location

Smart¹,

Pucci²,

Binder³

2009

The American Journal of Dermatopathology

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Primary cutaneous carcinosarcoma is an uncommon tumor that is characterized by an admixture of malignant epithelial and mesenchymal elements. To our knowledge, only approximately forty cases have been reported to date in the literature. The majority of these neoplasms occurred on the extremities and the head and neck region of older individuals. We report an additional case, which presented in an 87-year-old man in an unusual location, the buttock. Histologically, the lesion was characterized by a biphasic proliferation of malignant epithelial areas admixed with an infiltrative, poorly differentiated spindle cell component. The epithelial areas consisted of nodular aggregates of basaloid to squamoid cells forming focal ductal structures with central lumens containing proteinaceous debris. The sarcomatoid component consisted of malignant spindle to epithelioid-appearing cells admixed with bizarre-appearing tumor giant cells within a myxochondroid stroma. The epithelial cells showed positive staining with pan-cytokeratin, BerEP4, p63, and keratin 5/6 and were focally positive for S-100, calponin, and actin, consistent with myoepithelial differentiation. An epithelial membrane antigen stain highlighted the scattered ductal structures. The high-grade spindle cell areas were negative for S-100, actin, desmin, calponin, p63, epithelial membrane antigen, and keratin 5/6.

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Carcinosarcoma of the skin: Immunohistochemical and electron microscopic observations

Cited by 40 publications

References 9 publications

Sarcomatoid Basal Cell Carcinoma—Predilection for Osteosarcomatous Differentiation

Sarcomatoid Basal Cell Carcinoma—Predilection for Osteosarcomatous Differentiation

Basal cell carcinoma with a sarcomatous component (carcinosarcoma): A series of 5 cases and a review of the literature

Cutaneous Carcinosarcoma With Myoepithelial Differentiation: Immunohistochemical and Cytogenetic Analysis of a Case Presenting in an Unusual Location

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