Diagnosing Sarcomatoid Carcinoma and Carcinosarcoma of the Large Bowel

Virgilio, Edoardo; Mercantini, Paolo; Tarantino, Giulia; Masyuk, Maryna; Gumina, Giuseppe La; Ziparo, Vincenzo

doi:10.1177/1066896914542126

Cited by 3 publications

(3 citation statements)

References 4 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%

“…In the latter, the malignancy is truly biphasic, with 1 convincingly carcinomatous component and 1 lacking evidence of epithelial differentiation. This dichotomy may be somewhat useful for purposes of description and categorization, though real-world challenges in histologic interpretation of these unusual malignancies render it somewhat of a simplification, 51 and this distinction is unlikely to have prognostic significance. Regardless, as shown in our series and in the literature, both of these aggressive subtypes of carcinoma with sarcomatoid components are rare, are heterogeneous, and can comprise either intermixed or discrete elements, and the overall heading of “carcinoma with sarcomatoid components” thereby serves to convey the nature and prognosis of these malignancies without sacrificing crucial information.…”

Section: Discussionmentioning

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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confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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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 Sarcomatoid Carcinoma: a Rare Condition with Poor Outcomes

Welten

Fields

et al. 2020

Journal of Gastrointestinal Surgery

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Sarcomatoid Carcinoma of Colon: Report of a Case of Long-Term Survival with Disease

孙¹

2015

ACRPO

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Sarcomatoid carcinoma of colon is an extremely rare biphasic tumor characterized by a combination of malignant epithelial and sarcomatoid cells. The known characteristics are rapid growth, high rate of recurrence and metastasis, drugs resistance and poor prognosis with median survival less than 6 months. Precise diagnosis warranted histological examination, immunohistochemistry study and exclusion of other diseases, such as carcinosarcoma, sarcomatous mesothelioma and stromal tumor. Herein we report a case of patient who had a sarcomatoid carcinoma of ascending colon and still been alive for 44 months with liver and peritoneal metastasis after two subsequent operations and multiple cycles of chemotherapy. By far, only two patients with colon sarcomatoid carcinoma were reported to survive longer than this case, which deserved to be researched in details on diagnosis, clinical characteristics, therapy and outcome.

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Diagnosing Sarcomatoid Carcinoma and Carcinosarcoma of the Large Bowel

Cited by 3 publications

References 4 publications

Colorectal Carcinoma With Sarcomatoid Components

Colorectal Carcinoma With Sarcomatoid Components

Colorectal Sarcomatoid Carcinoma: a Rare Condition with Poor Outcomes

Sarcomatoid Carcinoma of Colon: Report of a Case of Long-Term Survival with Disease

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